Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis

被引:43
作者
Bi, Siwei [1 ]
Sun, Kaibo [2 ]
Chen, Shanshan [2 ]
Gu, Jun [3 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Burn & Plast Surg, Chengdu 610041, Sichuan, Peoples R China
[2] Sichuan Univ, West China Sch Med, Chengdu 610041, Sichuan, Peoples R China
[3] Sichuan Univ, West China Hosp, Dept Cardiovasc Surg, Chengdu 610041, Sichuan, Peoples R China
基金
中国国家自然科学基金;
关键词
MODIFIED LIMBERG FLAP; VIDEO-ASSISTED ABLATION; PRIMARY CLOSURE; KARYDAKIS FLAP; RHOMBOID EXCISION; RISK-FACTORS; MIDLINE; TRANSPOSITION; MANAGEMENT; SURGERY;
D O I
10.1038/s41598-020-70641-7
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The most appropriate surgical treatment for pilonidal sinus disease (PSD) is still in dispute. This study aims to comprehensively compare the outcomes of surgical interventions using network meta-analysis. Randomized controlled trial studies were searched systematically to identify all eligible studies in multiple databases and previous publications and Bayesian network meta-analysis was performed. Our primary outcome was the recurrence rate. Differences in the findings of the studies were explored in meta regressions and sensitivity analyses. The risk of bias of each study was assessed using the Cochrane risk of bias tool. Confidence in evidence was assessed using CINeMA (Confidence in Network Meta-Analysis). A total of 39 studies and 5,061 patients were identified and the most common surgical intervention was the Limberg flap. In network meta-analysis, modified Limberg flap and off-midline closure were associated with the lowest recurrence rate. However, the Karydakis flap was associated with shorter operation time by several minutes compared with other interventions and few significant results were found in other outcomes. Modified Limberg flap and off-midline closure provided relatively low recurrence and complications rates. Therefore, they could be two promising surgical interventions for PSD patients.
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页数:11
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