AIM: to estimate the effectiveness of minimally invasive methods for treatment of chronic inflammation in pilonidal sinus disease by systematic review.PATIENTS AND METHODS: fifty-two clinical trials were selected from 2,576 papers in databases for systematic review. It included the following methods: the fibrin glue, the sinusectomy, the video-assisted pilonidal sinus treatment, the laser coagulation and the chemical destruction using crystallized phenol or its solution. Regarding the last two methods, a meta-analysis was carried out.RESULTS: the meta-analysis demonstrated the high effectiveness of phenol and laser coagulation for pilonidal sinus disease. When comparing the results of phenol use and excisional techniques, there was a significant difference in higher frequency complications rate after excisional techniques (HR 0.42; 95% CI: 0.05–3.71), while the recurrence rate was the same (HR 0.98; 95% CI: 0.45–2.16). The probability of recurrence was significantly higher than after excision techniques in compare with SiLaC (HR 4.02; 95% CI: 1.13 14.3, p = 0.03). However, there was no significant differences in complication rate after SiLaC and excisional techniques (HR 0.63; 95% CI: 0.29–1.34).CONCLUSION: the chemical destruction and laser coagulation are the most effective methods for pilonidal sinus treatment.
Background: Obscure gastrointestinal bleedings accounting for 5%-30% of all gastrointestinal bleedings continue to be a challenge and usually originate from the small bowel.Clinical case: We present a case of a female patient hospitalized with signs of gastrointestinal bleeding three times within 3 months. We could not identify the source of bleeding using standard methods, such as abdominal computed tomography and ultrasonography, esophagogastroduodenoscopy, and colonoscopy. We detected a Meckel’s diverticulum during a diagnostic laparoscopy and performed wedge resection of the small bowel. Histopathology results revealed an acute progressive ulcer in the wall of the small bowel diverticulum.Conclusions: Diagnostic laparoscopy is one of the available minimally invasive procedures, which in some cases can successfully identify the source of small bowel bleeding.
The article presents a brief biography of an outstanding surgeon and a scientist of the Kuban region in 20th and 21st centuries Dr. Vladimir Bensman (11/18/1927). It is dedicated to his 95th anniversary. 72 years of his professional life were dedicated to medical science and national health care!
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