Year 2017 Vol. 25 No 6

GENERAL & SPECIAL SURGERY

M.Y. GAIN, S.V. SHAKHRAY, Y.M. GAIN

PILONIDAL SINUS: IS RADICAL OPERATION ALWAYS INDICATED?

SEE Belarusian Medical Academy of Post-Graduate Education, Minsk,
The Republic of Belarus

Objective. To study the treatment results of an acute inflammation of the sacrococcygeal region cyst in the distant period.
Methods. The study involved 481 patients suffering from an acute pilonidal sinus in which the abscess opening and draining was performed in 2007-2010. In the group A (250 patients) after the primary operation the second stage of treatment was applied including the radical operation to excise the cyst with the wound suturing by Donati. The group B includes 231 patients in whom the radical excision wasnt performed. The groups were gender and age comparable. Follow-up was carried out in 2017 in terms from 7 to 10 years after the primary operation.
Results. The recurrence rate after the radical excision (group A) was 10,8% (27 patients). 234 patients (93.6%) were subject to removal of postoperative sutures in terms up to 10 days. An average term of complete wound healing in the group A was 42 [28 - 57] (Me [25%-75%]) days. In the group B the abscess recurrence and repeated operation (abscess incision) was required in 74 patients (32.03%). In 157 (67.97%) cases, 7-10 years after the primary operation, absence of complaints (asymptomatic sinus, remission) was observed. While comparing two groups by general terms of disability for the period of 7-10 years, the significant advantages of the group B have been revealed: median of 12 days (group B) against 38 (in group A) (p=0.000319). Comparing two groups by the remote recurrence frequency has revealed the following data 10.8% (group A) against 32.03% (group B) (p = 0.00164).
Conclusions. The research result testifies to the necessity for further discussion concerning a rational surgical tactics, choice of indications for radical excision.

Keywords: pilonidal sinus, sacrococcygeal region, abscess, drainage, wound healing, cysts
p. 600-604 of the original issue
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Address for correspondence:
220013, Republic of Belarus,
Minsk, P. Brovki str., 3, b.3,
SEE Belarusian Medical Academy
of Post-Graduate Education,
Department of Emergency Surgery;
Tel.: 375-17-225-88-10,
E-mail: mishahain@tut.by,
Michail Y. Gain
Information about the authors:
Gain M.Y., PhD, Senior Lecturer of the Department of Emergency Surgery of SEE Belarusian Medical Academy of Post-Graduate Education.
Shakhray S.V., MD, Professor of the Department of Emergency Surgery of SEE Belarusian Medical Academy of Post-Graduate Education.
Gain Y.M., MD, Professor, Vice-rector for scientific work of SEE Belarusian Medical Academy of Post-Graduate Education.
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