Tension-free primary closure compared with modified Limberg flap for pilonidal sinus disease: a prospective balanced randomized study

Youssef, Tamer; El-Awady, Saleh; Farid, Mohamed

doi:10.4103/1110-1121.155716

Cited by 14 publications

(11 citation statements)

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“…Although the MEPC method does not require hospitalization, and allows for a quick return to work/school and has a smaller wound at the end of the surgery, it is interesting to note that both groups have similar patient satisfaction rates. This finding is in contradiction with the Youssef et al's thesis (26) that not only recurrence and complications but also other factors affecting quality of life should be taken into consideration in determining patient satisfaction rates. Since in our study we had information about the treatment processes, and outcomes only in the patient group, we could not obtain the opportunity to compare the treatment processes with the patients of the other group.…”

Section: Discussioncontrasting

confidence: 89%

Comparison of Minimal Excision and Primary Wound Closure with Limberg Flap Procedure in Adolescent Sacrococcygeal Pilonidal Sinus Surgery

Karaalı¹,

Sayan²,

Sert³

et al. 2020

BUCH

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Objective: Recently, minimally invasive methods have been used in surgical treatment of adult sacrococcygeal pilonidal sinus (SPS) instead of classical wide excisions. However, there are fewer data about minimally invasive methods in the adolescent age group. Therefore, we aimed to compare our adolescent patients undergoing minimal excision and primary closure (MEPC) with those undergoing Limberg flap (LF) method. Method: In this study, the data of 80 patients who were operated for sacrococcygeal pilonidal sinus between July 2014 and December 2017 were retrospectively reviewed. Patients who underwent minimal excision with primary closure (MEPC) or Limberg flap (LF) were included in the study. Patients were evaluated in terms of age, sex, body mass index (BMI), length of hospital stay, time to return to work/school, time to complete healing, complication, recurrence and patient satisfaction levels. Results: No significant difference was found between patient characteristics, complication, recurrence and patient satisfaction rates of these two groups. However, in terms of hospitalization and return to work/ school, MEPC group was found to be statistically advantageous compared with LF group. Conclusion: MEPC procedure has similar success rates in terms of recurrence, complications and patient satisfaction compared with LF. However, the MEPC procedure has advantages such as allowing faster return to work/school and not requiring hospitalization. Therefore, in adolescents with non-complex and uncommon SPS disease, MEPC procedure may be offered as an alternative treatment option to LF.

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Section: Discussioncontrasting

confidence: 89%

Comparison of Minimal Excision and Primary Wound Closure with Limberg Flap Procedure in Adolescent Sacrococcygeal Pilonidal Sinus Surgery

Karaalı¹,

Sayan²,

Sert³

et al. 2020

BUCH

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“…Data on recurrence and follow-up times in primary midline closures (not using advancement or rotation flap techniques) pertaining to 4,626 PSD patients which were extracted from 51 RCTs 5 , 9 , 10 , 19 , 20 , 22 , 25 – 29 , 31 , 32 , 35 , 37 , 41 – 73 , 235 , 236 , 748 . Among these patients, a recurrence of 2.1% (95% CI 1.7–2.6%) was observed in patients at 12 months, 7.0% (95% CI 6.0–8.0%) at 24 months, and 21.9% (95% CI 18.5–25.3%) at 60 months.…”

Section: Resultsmentioning

confidence: 99%

“…Data on recurrence and follow-up times pertaining to 2,380 patients treated for PSD by Limberg and Dufourmentel flap techniques were extracted from 36 RCTs 5 , 14 , 21 , 23 , 43 , 44 , 46 , 49 , 53 , 54 , 56 , 61 , 64 , 65 , 73 , 77 , 78 , 80 , 82 , 83 , 90 , 93 – 102 , 236 , 392 , 393 , 442 , 443 . Among these patients, a recurrence of 0.6% (95% CI 0.3–0.9%) was observed in patients at 12 months and 1.8% (95% CI 1.1–2.4%) at 24 months.…”

Section: Resultsmentioning

confidence: 99%

“…Data on recurrence and follow-up times pertaining to 6,366 patients treated for PSD by limited excision PSD treatment were extracted from 71 additional non-RCTs 52 , 61 , 69 , 72 , 73 , 75 , 81 , 83 , 88 , 94 , 106 , 114 , 119 , 121 , 124 , 125 , 131 , 140 , 142 , 144 , 149 , 160 , 208 , 221 , 226 , 248 , 249 , 261 , 285 , 293 , 295 , 319 , 321 , 322 , 400 , 410 , 416 , 536 , 609 , 625 – 656 . Among these patients, a recurrence of 5.0% (95% CI 4.3–5.6%) was observed in patients at 12 months, 6.8% (95% CI 6.0–7.7%) at 24 months, 16.2% (95% CI 14.3–18.2%) at 60 months, and 34.0% (95% CI 26.3–41.6%) at 120 months (Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

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Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Stauffer

Luedi

Kauf

et al. 2018

Sci Rep

189

191

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We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure.

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“…Studien war das Ergebnis statistisch signifikant (0-15 % vs. 11-23 %). Bei Sevinc et al[421] und Youssef[486] schnitt die sog. spannungsfreie Mittelliniennaht genauso gut ab wie die Limberg-bzw.…”

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S3-Leitlinie: Sinus pilonidalis. 2. revidierte Fassung 2020

2020

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Beteiligte Fachgesellschaften Deutsche Gesellschaft für Koloproktologie (DGK); federführend Deutsche Gesellschaft für Allgemein-und Viszeralchirurgie (DGAV) Chirurgische Arbeitsgemeinschaft für Coloproktologie (CACP) Berufsverband der Coloproktologen Deutschlands (BCD) Deutsche Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselkrankheiten (DGVS) Deutsche Dermatologische Gesellschaft (DDG) 1. Einleitung und Definition Der Pilonidalsinus oder Sinus pilonidalis (pilus = Haar, nidus = Nest) ist eine akut oder chronisch verlaufende Entzündung im subkutanen Fettgewebe, überwiegend im Bereich der Steißbeinregion.

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Tension-free primary closure compared with modified Limberg flap for pilonidal sinus disease: a prospective balanced randomized study

Cited by 14 publications

References 0 publications

Comparison of Minimal Excision and Primary Wound Closure with Limberg Flap Procedure in Adolescent Sacrococcygeal Pilonidal Sinus Surgery

Comparison of Minimal Excision and Primary Wound Closure with Limberg Flap Procedure in Adolescent Sacrococcygeal Pilonidal Sinus Surgery

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

S3-Leitlinie: Sinus pilonidalis. 2. revidierte Fassung 2020

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