Randomized comparative study of four lines of treatment of sacroccocygeal pilonidal sinus

الملخص EN

Pilonidal sinus (PNS) is a blind epithelial tract.

Various surgical and non-surgical modalities have been described for management of pilonidal disease.

The aim of the study is to compare different techniques of management of sacroccocygeal PNS.

A prospective randomized comparative study was carried out in a tertiary General Teaching Hospital.

192 Patients with PNS were randomly distributed for the definitive surgical procedure in to four groups:(1) Excision and healing by secondary intention (EHSI),(2) Excision and Primary Closure (EPC), (3)Karydakis Technique (KT) and (4)Limberg Flap (LF) techniques.Patients were seen regularly on postoperative days 5, 10, and 14 and then follow-up every 3 months for 24 months.

Primary outcomes were post-operative complication, recurrence rate , while secondary outcomes were type of anesthesia, ASA, complain, BMI, duration of operation, removal of drain ,removal of stitching and pain free time.The overall mean age of all patients with PNS was (24.05±5.93) years old and (54.5%) of patients were aged between 20-30 years.

(70.6%) of patients were males.

There were no significant Comparison of Type of PNS treated groups with ASA, Complain and BMI.

(60.0%) of all recurrence were among EPC type of operation.

(50.0%) of seroma were for each of LF and KT.(67.7%) of partial dehiscence were by LF.

There were significant Comparison of Type of PNS treated groups with pain free time, removal of stitching, removal of drain and duration of operation.

KT and LF were better than EPC and EHSI in the treatment of PNS disease because healing time is short, morbidity is low, low rate of recurrence because it flattens the natal cleft.

KT showed lower rate of partial dehiscence when compared with LF procedure.

KT is a promising procedure for the treatment of sacrococcygeal PNS.