Introduction and aim: Pilonidal sinus (PNS) is a common inflammatory condition of the gluteal region. Different methods were introduced for treatment. However, recurrence is still a significant problem after surgery and different approaches were described to lower the recurrence rate. But controversy exist regarding the standard surgical intervention. The current work aimed to compare between excision with off midline primary closure versus Limberg flap procedure in the treatment of sacrococcygeal PNS.
Methodology: Sixty patients with PNS were included and divided into two equal groups, the first for primary midline excision with closure, and the second treated by Limberg flap. Patients were assessed by clinical evaluation and after surgery, the recurrence rate was documented through the first year. In addition, complications rate and times to restore the normal daily activities were documented and compared between groups.
Results: Both groups were comparable regarding all preoperative variables. The operative time was significantly short among group I than group II (31.6± 6.5 vs 51.6± 6.4 minutes). The duration of hospital stay, time to return to work, drainage amount, time to stitch removal, time to walk pain-free and time to painless toilet seat were significantly shorter in group I. However, cosmetic score was significantly higher in group I than group II. Finally, the recurrence rate was significantly higher in group I than group II (20.0% vs 0.0%). The recurrence was significantly associated with hairy skin, positive family history, diabetes mellitus, higher BMI, and history of previous PNS.
Conclusion: Primary midline closure of PNS is superior than the Limberg flap in operative time and times to return to normal daily activities. However, it had a higher recurrence rate. Thus, Limberg flap is advocated for PNS.
Article informationBackground: Adhesive intestinal obstruction one of the common medical cause of admission in emergency. It is a serious problem lead to gut and gynecological pelvic complication.Imbalance between formation of fibrin and biodegradation is critical in adhesion formation. The advantage of laparoscopy over open surgery is that adhesion is by far less prominent and so the recurrence of adhesion is decreased.
Aim of the work:To evaluate the accessibility of using laparoscopy as a safe tool in the management of adhesive intestinal obstruction.Patients and Methods: This study was done in General Surgery Department, Faculty of Medicine, Al-Azhar University [New Damietta] on 20 patients complaining from adhesive intestinal obstruction all of them were managed laparoscopically for removal of adhesions over of six months.
Results:The mean operative time was 73.4 min and about 95% of cases completed laparoscopically, the rest of the cases converted to open surgery due to severe adhesion or intraoperative complication.
Conclusion:Laparoscopy is safe and effective in management of partial or complete adhesive intestinal obstruction; conversion to open should be considered in severe adhesion.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.