Unroofing and Marsupialization vs. Rhomboid Excision and Limberg Flap in Pilonidal Disease: A Prospective, Randomized, Clinical Trial

被引:60
|
作者
Karakayali, Feza [1 ]
Karagulle, Erdal [1 ]
Karabulut, Zulfikar [1 ]
Oksuz, Ergun [2 ]
Moray, Gokhan [1 ]
Haberal, Mehmet [1 ]
机构
[1] Baskent Univ, Fac Med, Dept Gen Surg, TR-06490 Ankara, Turkey
[2] Baskent Univ, Fac Med, Family Med Unit, TR-06490 Ankara, Turkey
关键词
Healing time; Limberg flap; Marsupialization; Pilonidal sinus; Rhomboid excision; Unroofing; SURGICAL-TREATMENT; PRIMARY CLOSURE; TRANSPOSITION FLAP; SINUS DISEASE;
D O I
10.1007/DCR.0b013e31819a3ec0
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND: The aim of the study was to compare clinical outcomes and quality of life in patients undergoing surgery for pilonidal disease with unroofing and marsupialization (UM) or rhomboid excision and Limberg flap (RELP) procedures. METHODS: One hundred forty consecutive patients with pilonidal sinus were randomly assigned to receive either UM or RELP procedures. A specifically designed questionnaire was administered at three months to assess time from the operation until the patient was able to walk, return to daily activities, or sit without pain, time to return to work or school, and time to healing. Postoperative pain was assessed with a visual analog scale and the McGill Pain Questionnaire. Patients' quality of life was evaluated with the Cardiff Wound Impact Schedule (CWIS). Questionnaires were administered by a clinician blinded to treatment. RESULTS: Compared with RELP, patients receiving UM had significantly shorter duration of operation and hospital stay, shorter time periods to walk, return to daily activities, or sit without pain and to return to work or school, and fewer complications. Time to final healing was significantly shorter and quality of life scores on the CWIS were higher in patients receiving RELP than in those receiving UM. Patients with UM had lower levels of pain one week after surgery. CONCLUSION: The unroofing and marsupialization procedure provides more clinical benefits in the treatment of pilonidal disease than rhomboid excision and Limberg flap and should be considered the procedure of choice. However, it may be associated with more inconvenience in wound care and longer healing time than rhomboid excision and Lindberg flap.
引用
收藏
页码:496 / 502
页数:7
相关论文
共 50 条
  • [31] Limberg Flap Versus Bascom Cleft Lift Techniques for Sacrococcygeal Pilonidal Sinus: Prospective, Randomized Trial
    Ali Guner
    Aydin Boz
    Omer Faruk Ozkan
    Omer Ileli
    Can Kece
    Erhan Reis
    World Journal of Surgery, 2013, 37 : 2074 - 2080
  • [32] Limberg Flap Versus Bascom Cleft Lift Techniques for Sacrococcygeal Pilonidal Sinus: Prospective, Randomized Trial
    Guner, Ali
    Boz, Aydin
    Ozkan, Omer Faruk
    Ileli, Omer
    Kece, Can
    Reis, Erhan
    WORLD JOURNAL OF SURGERY, 2013, 37 (09) : 2074 - 2080
  • [33] Outcome of dufourmentel flap versus conventional rhomboid (Limberg flap) in the treatment of complex pilonidal sinus: a randomized controlled study
    Abdelrahman, Emad M.
    Kilany, Elsayed O.
    Shoulah, Ahmed A.
    Ghazy, Amal H.
    Elgazzar, Sherif A.
    EGYPTIAN JOURNAL OF SURGERY, 2024, 43 (01): : 101 - 108
  • [34] Pit picking vs. Limberg flap vs. primary open method to treat pilonidal sinus disease - A cohort of 327 consecutive patients
    Doll, Dietrich
    Petersen, Sven
    Andreae, Octavia Alexandra
    Matner, Hanne
    Albrecht, Henning
    Bruegger, Lukas E.
    Luedi, Markus M.
    Puhl, Gero
    INNOVATIVE SURGICAL SCIENCES, 2022, 7 (01): : 23 - 29
  • [35] Lower recurrence rate for limberg vs. V-Y flap for pilonidal sinus
    Unalp, Haluk R.
    Derici, Hayrullah
    Kamer, Erdinc
    Nazli, Okay
    Onal, Mehmet Ali
    DISEASES OF THE COLON & RECTUM, 2007, 50 (09) : 1436 - 1444
  • [36] Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study
    Tokac, Mehmet
    Dumlu, Ersin Gurkan
    Aydin, Murat Seyit
    Yalcin, Abdussamed
    Kilic, Mehmet
    INTERNATIONAL SURGERY, 2015, 100 (05) : 870 - 877
  • [37] Primary wound closure with a Limberg flap vs. secondary wound healing after excision of a pilonidal sinus: amulticentre randomised controlled study
    Kaser, S. A.
    Zengaffinen, R.
    Uhlmann, M.
    Glaser, C.
    Maurer, C. A.
    COLOPROCTOLOGY, 2015, 37 (06) : 373 - 380
  • [38] Primary wound closure with a Limberg flap vs. secondary wound healing after excision of a pilonidal sinus: a multicentre randomised controlled study
    S. A. Käser
    R. Zengaffinen
    M. Uhlmann
    C. Glaser
    C. A. Maurer
    International Journal of Colorectal Disease, 2015, 30 : 97 - 103
  • [39] Conservative Sinusectomy vs. excision and primary off-midline closure for pilonidal disease: a randomized controlled trial
    Sotirios Georgios Popeskou
    Barbara Pravini
    Sofoklis Panteleimonitis
    Antoniacopo Ferrario Di Tor Vajana
    Alice Vanoni
    Mike Schmalzbauer
    Alberto Posabella
    Dimitri Christoforidis
    International Journal of Colorectal Disease, 2020, 35 : 1193 - 1199
  • [40] Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study
    Ates, Mustafa
    Dirican, Abuzer
    Sarac, Mehmet
    Aslan, Ahmet
    Colak, Cemil
    AMERICAN JOURNAL OF SURGERY, 2011, 202 (05): : 568 - 573