PDF(Pubmed)
Abstract：
UNASSIGNED: We evaluated the clinical effect of utilizing a Limberg rhomboid flap graft in conjunction with Enhanced Recovery After Surgery (ERAS) protocols for the management of pilonidal sinus in the sacrococcygeal region to demonstrate the feasibility of applying ERAS to the treatment of pilonidal sinus.
UNASSIGNED: Between January 2010 and August 2018, prospective data analysis was undertaken on 109 patients who received surgical treatment for pilonidal sinus in the sacrococcygeal region at the Department of Colorectal and Anal Surgery, Jingzhou Hospital affiliated to Yangtze University, and Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine. The patients were randomly separated into two groups based onoperation technique: the control group (pilonidal sinus resection with primary suture) and the observation group (pilonidal sinus resection with Limberg flap graft). Some patients in the above two groups received ERAS after surgery, which included early feeding and early ambulation, etc. Therefore, we further subdivided each group into group A (without ERAS) and group B (with ERAS) according to whether they received ERAS. Comparative analysis was conducted to assess differences in pertinent data before and after surgery across the respective groups.
UNASSIGNED: The length of postoperative hospitalization was shorter and wound dehiscence was more common in control group B than in control group A [(9.00 ± 1.20) vs. (11.07 ± 1.78), 26.7% (8/30) vs. 7.1% (2/28), P < 0.05]. Observation group B exhibited significantly shorter wound recovery periods and postoperative hospital stays compared to observation group A [(8.08 ± 1.20) vs. (9.16 ± 2.21), (26.23 ± 3.97) vs. (29.08 ± 4.74), P < 0.05]. The hospitalization duration and wound healing time in observation group B were notably shorter than those observed in control group B [(8.08 ± 1.20) vs. (9.00 ± 1.20), [26.23 ± 3.97 vs. (43.67 ± 7.26), P < 0.05], but the operation time was longer and scar acceptance was lower [(78.85 ± 10.16) vs. (43.30 ± 6.06), (4.00 ± 0.69) vs. (7.53 ± 0.86), P < 0.05]. The VAS score, infection rate, wound dehiscence rate, subcutaneous hematoma rate and 5-year recurrence rate in observation group B were lower than those in control group B [(5.00 ± 1.39) vs. (7.13 ± 0.78), 3.8% (1/26) vs. 23.3% (7/30), 3.8% (1/26) vs. 26.7% (8/30), 3.8% (1/26) vs. 26.7%(8/30), 7.7% (2/26) vs. 30.0% (9/30), P < 0.05], but the rate of flap ischemia or necrosis was higher [15.4% (4/26) vs. 0(0/30), P < 0.05].
UNASSIGNED: The combination of ERAS with pilonidal sinus resection using Limberg flap graft demonstrated a reduction in infection rates, wound dehiscence, subcutaneous hematoma occurrence, and recurrence rates, along with alleviation of postoperative pain and acceleration of healing time. Comparatively, this approach offers superior advantages over pilonidal sinus resection with primary suture in the management of sacrococcygeal pilonidal sinus.
UNASSIGNED: Between January 2010 and August 2018, prospective data analysis was undertaken on 109 patients who received surgical treatment for pilonidal sinus in the sacrococcygeal region at the Department of Colorectal and Anal Surgery, Jingzhou Hospital affiliated to Yangtze University, and Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine. The patients were randomly separated into two groups based onoperation technique: the control group (pilonidal sinus resection with primary suture) and the observation group (pilonidal sinus resection with Limberg flap graft). Some patients in the above two groups received ERAS after surgery, which included early feeding and early ambulation, etc. Therefore, we further subdivided each group into group A (without ERAS) and group B (with ERAS) according to whether they received ERAS. Comparative analysis was conducted to assess differences in pertinent data before and after surgery across the respective groups.
UNASSIGNED: The length of postoperative hospitalization was shorter and wound dehiscence was more common in control group B than in control group A [(9.00 ± 1.20) vs. (11.07 ± 1.78), 26.7% (8/30) vs. 7.1% (2/28), P < 0.05]. Observation group B exhibited significantly shorter wound recovery periods and postoperative hospital stays compared to observation group A [(8.08 ± 1.20) vs. (9.16 ± 2.21), (26.23 ± 3.97) vs. (29.08 ± 4.74), P < 0.05]. The hospitalization duration and wound healing time in observation group B were notably shorter than those observed in control group B [(8.08 ± 1.20) vs. (9.00 ± 1.20), [26.23 ± 3.97 vs. (43.67 ± 7.26), P < 0.05], but the operation time was longer and scar acceptance was lower [(78.85 ± 10.16) vs. (43.30 ± 6.06), (4.00 ± 0.69) vs. (7.53 ± 0.86), P < 0.05]. The VAS score, infection rate, wound dehiscence rate, subcutaneous hematoma rate and 5-year recurrence rate in observation group B were lower than those in control group B [(5.00 ± 1.39) vs. (7.13 ± 0.78), 3.8% (1/26) vs. 23.3% (7/30), 3.8% (1/26) vs. 26.7% (8/30), 3.8% (1/26) vs. 26.7%(8/30), 7.7% (2/26) vs. 30.0% (9/30), P < 0.05], but the rate of flap ischemia or necrosis was higher [15.4% (4/26) vs. 0(0/30), P < 0.05].
UNASSIGNED: The combination of ERAS with pilonidal sinus resection using Limberg flap graft demonstrated a reduction in infection rates, wound dehiscence, subcutaneous hematoma occurrence, and recurrence rates, along with alleviation of postoperative pain and acceleration of healing time. Comparatively, this approach offers superior advantages over pilonidal sinus resection with primary suture in the management of sacrococcygeal pilonidal sinus.
摘要：
■我们评估了使用Limberg菱形皮瓣移植结合术后增强恢复（ERAS）方案处理骶尾部的藏毛窦的临床效果，以证明将ERAS应用于治疗的可行性。
在2010年1月至2018年8月之间，对109例患者进行了前瞻性数据分析，这些患者在结直肠和肛门外科的骶尾部区域接受了藏毛窦手术治疗，长江大学附属荆州医院,南京中医药大学泰州附属医院.根据手术技术将患者随机分为两组：对照组（带一期缝合的藏毛窦切除术）和观察组（带Limberg皮瓣移植的藏毛窦切除术）。上述两组部分患者术后均接受ERAS,包括早期进食和早期行走，等。因此,根据是否接受ERAS,我们将每组再分为A组(无ERAS)和B组(有ERAS).进行比较分析以评估各组之间手术前后相关数据的差异。
■与对照组A相比，对照组B的术后住院时间更短，伤口裂开更常见[（9.00±1.20）vs.(11.07±1.78),26.7%（8/30）与7.1%（2/28），P<0.05]。观察组B与观察组A相比伤口恢复期和术后住院时间明显缩短[(8.08±1.20)vs.(9.16±2.21),（26.23±3.97）vs.(29.08±4.74),P<0.05]。观察B组住院时间及创面愈合时间明显短于对照组[(8.08±1.20)vs.(9.00±1.20),[26.23±3.97vs.(43.67±7.26),P<0.05],但手术时间较长，疤痕接受度较低[(78.85±10.16)vs.(43.30±6.06),(4.00±0.69)vs.(7.53±0.86),P<0.05]。VAS评分,感染率,伤口开裂率，观察组B皮下血肿发生率及5年复发率低于对照组[(5.00±1.39)vs.(7.13±0.78),3.8%（1/26）与23.3%（7/30），3.8%（1/26）与26.7%（8/30），3.8%（1/26）与26.7%（8/30），7.7%（2/26）与30.0%（9/30），P<0.05],但皮瓣缺血或坏死的发生率较高[15.4%(4/26)vs.0(0/30),P<0.05]。
■ERAS与使用Limberg皮瓣移植的藏毛窦切除术相结合显示感染率降低，伤口裂开,皮下血肿的发生，和复发率，随着术后疼痛的减轻和愈合时间的加快。相对而言,在骶尾部藏毛窦的治疗中，这种方法比一期缝合的藏毛窦切除术具有优越的优势。
在2010年1月至2018年8月之间，对109例患者进行了前瞻性数据分析，这些患者在结直肠和肛门外科的骶尾部区域接受了藏毛窦手术治疗，长江大学附属荆州医院,南京中医药大学泰州附属医院.根据手术技术将患者随机分为两组：对照组（带一期缝合的藏毛窦切除术）和观察组（带Limberg皮瓣移植的藏毛窦切除术）。上述两组部分患者术后均接受ERAS,包括早期进食和早期行走，等。因此,根据是否接受ERAS,我们将每组再分为A组(无ERAS)和B组(有ERAS).进行比较分析以评估各组之间手术前后相关数据的差异。
■与对照组A相比，对照组B的术后住院时间更短，伤口裂开更常见[（9.00±1.20）vs.(11.07±1.78),26.7%（8/30）与7.1%（2/28），P<0.05]。观察组B与观察组A相比伤口恢复期和术后住院时间明显缩短[(8.08±1.20)vs.(9.16±2.21),（26.23±3.97）vs.(29.08±4.74),P<0.05]。观察B组住院时间及创面愈合时间明显短于对照组[(8.08±1.20)vs.(9.00±1.20),[26.23±3.97vs.(43.67±7.26),P<0.05],但手术时间较长，疤痕接受度较低[(78.85±10.16)vs.(43.30±6.06),(4.00±0.69)vs.(7.53±0.86),P<0.05]。VAS评分,感染率,伤口开裂率，观察组B皮下血肿发生率及5年复发率低于对照组[(5.00±1.39)vs.(7.13±0.78),3.8%（1/26）与23.3%（7/30），3.8%（1/26）与26.7%（8/30），3.8%（1/26）与26.7%（8/30），7.7%（2/26）与30.0%（9/30），P<0.05],但皮瓣缺血或坏死的发生率较高[15.4%(4/26)vs.0(0/30),P<0.05]。
■ERAS与使用Limberg皮瓣移植的藏毛窦切除术相结合显示感染率降低，伤口裂开,皮下血肿的发生，和复发率，随着术后疼痛的减轻和愈合时间的加快。相对而言,在骶尾部藏毛窦的治疗中，这种方法比一期缝合的藏毛窦切除术具有优越的优势。
