Laser hemorrhoidoplasty (LHP) using a 1470 nm radial fibre laser – early efficacy assessment based on own data

Nowa Medycyna ◽  
2020 ◽  
Vol 27 (4) ◽  
Author(s):  
Sławomir Glinkowski ◽  
Daria Marcinkowska
Keyword(s):  
Hospital Stay ◽  
Opioid Analgesics ◽  
Daily Activities ◽  
Fibre Laser ◽  
Haemorrhoidal Disease ◽  
First Case ◽  
Conventional Hemorrhoidectomy ◽  
Efficacy Assessment ◽  
Grade Ii ◽  
The Mean

Introduction. Haemorrhoidal disease is one of the most common colorectal conditions. Although many treatment methods have been developed, Milligan-Morgan hemorrhoidectomy remains the most widely practised surgical technique. Aim. The aim of this study was to compare the effectiveness of Milligan-Morgan hemorrhoidectomy and laser hemorrhoidoplasty using a 1470 nm radial fibre laser. The following variables were analysed: procedure duration, length of procedure-related hospital stay, postoperative pain, and time to return to normal daily activities. Material and methods. The study group included 178 patients (women 45%, men 55%), including 82 patients undergoing laser hemorrhoidoplasty and 96 patients undergoing Milligan-Morgan hemorrhoidectomy. The mean age of the patients was 50 years, with the youngest patient aged 19 years and the oldest patient aged 65 years. The mean age of patients was lower in the laser hemorrhoidoplasty group (54.23 vs 45.15 years). The mean follow-up was 14 months (3-35 years). Results. The mean duration of laser hemorrhoidoplasty was shorter than that of Milligan-Morgan hemorrhoidectomy (13.9 vs. 22.3 min). There was no need for a revision surgery after laser hemorrhoidoplasty, whereas reoperation was necessary in three cases after classical hemorrhoidectomy. The mean and the shortest time of return to work was 14 and 5 days for laser hemorrhoidoplasty compared to 21 and 15 days for classical hemorrhoidectomy, respectively. Opioid analgesics were needed in 51% of patients after Milligan-Morgan hemorrhoidectomy and none of the patients after laser hemorrhoidoplasty. Conclusions. Laser hemorrhoidoplasty is an effective treatment approach in grade II-IV haemorrhoidal disease. It is associated with less pain compared to conventional hemorrhoidectomy. The duration of both the procedure itself and hospital stay is shorter after laser hemorrhoidoplasty compared to Milligan-Morgan hemorrhoidectomy. The return to normal daily activities is also faster in the first case.

scholarly journals Endoscopic, Single-Session Management of Encrusted, Forgotten Ureteral Stents

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 58 ◽  
Author(s):  
Volkan Ulker ◽  
Orcun Celik
Keyword(s):  
Hospital Stay ◽  
Treatment Options ◽  
Operating Time ◽  
Operation Time ◽  
Ureteral Stents ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Clavien Grade ◽  
Grade Ii ◽  
The Mean

Background and Objectives: Remained or forgotten ureteral double-J stents may cause serious complications. Removing of an encrusted, forgotten stent can be challenging. We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity. Materials and Methods: Eleven men and six women (mean 48.58 ± 14.48 years of age) with 18 encrusted forgotten stents (mean 16.4 ± 13.25 months of indwelling) were treated at our clinic. All patients underwent the operation after negative urine cultures were obtained. Their medical records were retrospectively reviewed and analyzed in terms of number of interventions required to remove the stent, operation time, complications, hospital stay and stone-free rate. Results: According to the Forgotten-Encrusted-Calcified (FECal) classification, the most common form of stent encrustation was grade III (64.7%) and 17.6% of the stents were fragmented. Four of 17 patients were initially treated with extracorporeal shock-wave lithotripsy. The patients required a mean of two endoscopic interventions for removing the encrusted stent and all stents were removed endoscopically in a single session. The mean operating time was 63.3 ± 41.8 minutes. Cystolithotripsy followed by ureteroscopy was the most common intervention (41.1%). Of the 17 patients, peroperative and postoperative complications were Clavien grade I in two, grade II in two and grade IIIb in one. The mean hospital stay was 1.3 ± 0.99 days. All patients were stone-free after a month of stent removal. Conclusions: The endourological removal of the encrusted forgotten stents in a single session is feasible and effective with a minimal morbidity. The treatment strategy should be to minimize the number of interventions.

scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

Short-term Results Of Sclerotherapy With 3% Polidocanol Foam For Symptomatic Second- And Third-degree Haemorrhoidal Disease

2019 ◽  
Author(s):  
Pierluigi Lobascio ◽  
Rita Laforgia ◽  
Eugenio Novelli Novelli ◽  
Fabrizio Perrone ◽  
Maria Di Salvo ◽  
...  
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Cost Effective ◽  
Daily Activities ◽  
Anal Continence ◽  
Short Term ◽  
Haemorrhoidal Disease ◽  
Post Operative Pain ◽  
Symptom Scores ◽  
The Mean

Abstract Background.Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the haemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods.A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analogue scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through a self-reported questionnaire and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results. Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD ± 12) years. The mean operative time was 4.5 (2-6; SD ± 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and T5 symptom scores in each patient, showed a mean change of 7.88 (p<0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions.ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.

scholarly journals A Prospective Comparative Study: Stapler Hemorrhoidopexy vs Laser Hemorrhoidoplasty in the Treatment of Hemorrhoids

2020 ◽  
pp. 10-23
Author(s):  
Anshuman Kaushal ◽  
Aakanksha Aggarwal ◽  
Amanpriya Khanna ◽  
Rajesh Agarwal ◽  
Dhruv N. Kundra ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Comparative Study ◽  
Hospital Stay ◽  
Postoperative Bleeding ◽  
Early Return ◽  
Severe Postoperative Pain ◽  
Prospective Comparative Study ◽  
Grade Ii ◽  
The Mean ◽  
Group 2

Aims: Stapler hemorrhoidopexy (SH) has evolved over time as a procedure of choice over conventional surgery due to less postoperative pain. Laser hemorrhoidoplasty (LH) is a novel procedure aimed at shrinking the terminal branches of hemorrhoidal arteries with fewer complications. The present study is aimed to compare these procedures (SH and LH). Study Design: Prospective comparative study. Place and Duration of Study: Patients operated for hemorrhoids at the Department of General, MI & Bariatric Surgery, Artemis Hospitals, Gurgaon from April 2018 to March 2019. Methodology: 50 patients with grade II-III hemorrhoids were allocated to two groups: Stapler hemorrhoidopexy (SH) and Laser hemorrhoidoplasty (LH) with 25 patients in each group. Results were compared and patients were followed up for minimum period of 3 months. Results: The mean operative time was 24.6 min (LH) and 28.6 min (SH) (P =.122). The average blood loss was 8.32 ml (LH) and 11.64 ml (SH) (P <.05). The mean hospital stay 21.44 hours (LH) and 32.64 hours (SH) (P <.05). Mean postoperative pain score (VAS) at 12 hours was 2.64 (LH) and 4.76 (SH) (P <.05), at 24 hours was 1.88 (LH) and 3.6 (SH) (P <.05), at 1 week was 0.36 (LH) and 0.88 (SH) (P =.054) and at 3 months 0.04 (LH) and 0.12 (SH) (P =.53). One patient in LH (4%) had postoperative bleeding on 4th postoperative day. In SH group, 2 (8%) had severe postoperative pain with VAS > 8, requiring longer hospital stay, 2 (8%) had bleeding on the same day, 1 (4%) had bleeding on follow up and 1 (4%) had recurrence. Conclusion: In terms of early postoperative pain and complications, LH offers better results as compared to SH. It was associated with a shorter hospital stay and early return to work. No significant complications were noted in LH compared to SH. LH is an extremely viable alternative to the popular SH for grade II-III hemorrhoids.

scholarly journals Short-term Results Of Sclerotherapy With 3% Polidocanol Foam For Symptomatic Second- And Third-degree Haemorrhoidal Disease

2019 ◽  
Author(s):  
Pierluigi Lobascio ◽  
Rita Laforgia ◽  
Eugenio Novelli Novelli ◽  
Fabrizio Perrone ◽  
Maria Di Salvo ◽  
...  
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Cost Effective ◽  
Daily Activities ◽  
Anal Continence ◽  
Short Term ◽  
Haemorrhoidal Disease ◽  
Post Operative Pain ◽  
Symptom Scores ◽  
The Mean

Abstract Background . Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the haemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods . A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analogue scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through the Hemorrhoid Severity Score (HSS) and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results . Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD ± 12) years. The mean operative time was 4.5 (2-6; SD ± 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and T5 symptom scores in each patient, showed a mean change of 7.88 (p<0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions . ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.

scholarly journals AN OBSERVATIONAL COMPARATIVE STUDY OF STAPLER HEMORRHOIDOPEXY AND THE MILLIGAN MORGAN OPEN HEMORRHOIDECTOMY IN TERTIARY CARE CENTER OF CENTRAL INDIA

2020 ◽  
Vol 8 (11) ◽  
pp. 264-272
Author(s):  
Rohan Gupta ◽  
◽  
Sanjay Prasad ◽  
Akhilesh Kumar Patel ◽  
Rohan Chaphekar ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Coming Out ◽  
Mean Difference ◽  
Open Group ◽  
Female Ratio ◽  
Open Hemorrhoidectomy ◽  
Duration Of Surgery ◽  
Grade Ii ◽  
The Mean ◽  
Grade Iii

Introduction: Hemorrhoids also called piles. It is vascular structures in the analcanal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed. the unqualified term "hemorrhoid" is often used to refer to the disease. Material and method: The present study was conducted in the Department of Surgery, Sri Aurobindo Medical College & PG Institute Indore M.P over a duration of one and half years (November 2017 to May 2019). The study was a cross-sectional prospective study and it compares results between Milligan Morgan haemorrhoidectomy and Stapler haemorrhoidopexy for the management of grade 2, 3, and 4 hemorrhoids. Results: In this study, most of the cases were between age group 30-50 [50%] years with the mean age being 43 years. Hemorrhoids more common in males 30 [65%], male: female ratio being 3:1. The most common presentation in hemorrhoids was bleeding per rectum in 47% followed by something coming out per rectum in 43 % & painful defecation in 10 % cases respectively. The duration of surgery was significantly low in the stapler group with meantime being 44.25 compared to open group 63 with the mean difference being 19 mins (P < 0.001). In 17of 21 [85%] whereas in grade IV all 09 [100%] patients had open surgery grade III had mixed options 03/07 [30/70 %] stapler & open respectively. Postoperatively the mean duration of hospital stay in stapler group was 4.15± 1.03 as compared to the open group 6.05 ± 1.84 with the mean difference being 2 days (P<0.001). The duration of recovery was significantly faster in stapler group with the mean hospital stay being 7.55 as compared to the open group 12.45 with mean difference being 5 days(P<0.001). Postoperative bleeding was found in both the groups which eventually subsided completely in stapler group on POD - 7 and only 3[7.5%]. Patients had bleeding on POD – 7 in the open group. (P < 0.001). The findings were statistically significant as suggested by P-Value. Urinary Retention was found in both groups i.e. 5% and 7.5% in stapler and open group respectively. (P= 0.632). Conclusion: The results of this study concluded that Stapler hemorrhoidopexy had lesser operating time, lower duration of hospital stays, and quicker recovery with less postoperative pain & bleeding as compared to Open hemorrhoidectomy. Hence it was concluded that stapler hemorrhoidopexy is a better option as compared to open hemorrhoidectomyfor grade II. grade III, & a few selected cases of grade IV hemorrhoids. patients stapler procedure was choice in grade II haemorrhoids.

Stapled Haemorrhoidopexy in the Treatment of Haemorrhoidal Disease: A Prospective Study

2020 ◽  
Vol 38 (3) ◽  
pp. 126-134
Author(s):  
Md Jahangir Hossan Bhuiyan ◽  
AMM Yahia ◽  
Farhana Begum ◽  
Mainuddin Ahmed ◽  
Nafiz Imtiaz Uddin Ahmed
Keyword(s):  
Hospital Stay ◽  
Stapled Haemorrhoidopexy ◽  
Patient’S Satisfaction ◽  
Haemorrhoidal Disease ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Short And Long Term ◽  
The Mean ◽  
Grade 3 ◽  
A Prospective Study

Background: Haemorrhoids are usually managed by open haemorrhoidectomy which is associated with postoperative pain, prolong hospital stay, longer convalescence and late return to normal activities. Stapled haemorrhoidopexy is a newer alternative for the treatment of haemorrhoid. The present study was designed to evaluate this technique in terms of duration of surgery & hospital stay, complications, convalescence, time return to normal activities, cost effectiveness and patient’s satisfaction. Materials and methods: One hundred and sixty patients of either sex who fulfilled the criteria were included in this study. More than 90% of the patients were in grade 3 & 4. All data were prospectively collected and examined. The patients were evaluated in terms of demographic properties, complaints on admission and postoperative complication. Results: 69.4% were male and 30.6% were female. Mean age was 40.93 years. Grade 3 haemorrhoid was present in 73.75% cases, Grade 4 was 18.12% cases, Grade 1 and Grade 2 were in 8.13% cases. The mean duration of surgery was 30 minutes. The mean duration of hospitalization was 36 hours. Intraoperative bleeding was observed in 9.38% patients. Reactionary haemorrhage was seen in 3.75% patients. Postoperative mild pain in 3.12% patients and residual prolapse in 1.25% cases. Conclusion: Stapled haemorrhoidopexy is safer alternative to open haemorrhoidotectomy with many short and long term benefits. J Bangladesh Coll Phys Surg 2020; 38(3): 126-134

scholarly journals Laparoscopic donor nephrectomy: technique and outcome, a single-center experience

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Osama Zaytoun ◽  
Moustafa Elsawy ◽  
Kareem Ateba ◽  
Ayman Khalifa ◽  
Ahmed Hamdy ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Graft Function ◽  
Length Of Hospital Stay ◽  
Donor Nephrectomy ◽  
Laparoscopic Donor Nephrectomy ◽  
Single Center Experience ◽  
Clavien Grade ◽  
Grade Ii ◽  
The Mean ◽  
Operative Notes

Abstract Background Laparoscopic donor nephrectomy (LDN) has been established as a surgical standard for living kidney donation. The aim of this work is to report our own experience with LDN regarding outcome and technique. Methods We prospectively identified 110 LDN cases between May 2017 and April 2020. Donor case files and operative notes were analyzed for age, sex, laterality, body mass index, warm ischemia time (WIT), intraoperative and postoperative complications, operative time, and length of hospital stay (LOS). Data were analyzed using SPSS version 10 (SPSS: An IBM Company, IBM Corporation, Armonk, NY, the USA). Results The mean age was 38 years, and 77% were males. Three cases (2.72%) required conversion to conventional open donor nephrectomy (ODN). Nevertheless, none of cases required intraoperative blood transfusion. The mean WIT was 2.6 min. Two cases (1.8%) developed major vascular injury (Clavien grade IIIb) and required conversion to ODN. Postoperatively, one patient (0.9%) needed transfusion of one unit of packed RBCs (Clavien grade II). The mean LOS was 2 days. Most common early postoperative complication was ileus (Clavien grade II) that developed in 4 (3.6%) cases. Incisional hernia (Clavien grade IIIb) was encountered in two (1.8%) cases. Two (1.8%) cases developed wound infection at the incision site and treated conservatively (Clavien grade I). Conclusions LDN is a safe technique with accepted intraoperative and postoperative morbidity. It offers short hospital stay, better cosmesis and early convalescence. In experienced hands, it can effectively deal with various vascular and ureteral anomalies without compromising early graft function.

Laparoscopy and endoscopy cooperative surgery for gastric tumor.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 168-168
Author(s):  
Ozawa Hiroki ◽  
Hirofumi Kawakubo ◽  
Shuhei Mayanagi ◽  
Kazumasa Fukuda ◽  
Osamu Goto ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wedge Resection ◽  
Operation Time ◽  
Tumor Location ◽  
Postoperative Hospital Stay ◽  
Submucosal Tumors ◽  
Gastric Cancers ◽  
Gastric Submucosal Tumors ◽  
Grade Ii ◽  
The Mean

168 Background: Laparoscopic wedge resection is widely performed for managing gastric submucosal tumors (SMTs) that measure ≤5 cm in diameter. Laparoscopy and endoscopy cooperative surgery (LECS) is performed to ensure a sufficient margin while avoiding deformation or stenosis. Methods: We conducted a retrospective review of the data of 76 patients who underwent LECS for SMTs or early gastric cancers at our institution between April 2012 and July 2017. While Non-exposed Endoscopic Wall-inversion Surgery (NEWS) was performed for tumors with a major axis diameter of ≤5 cm and minor axis diameter of ≤3 cm, for other tumors, we adopted classical LECS or used the combination of laparoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET). Results: The tumor was located in the upper-/middle-/lower-third of the stomach in 49/20/7 cases. The mean operation time was 201.7 ± 66.2 min, and the mean blood loss was 4.7 ± 12.8 ml. The mean tumor size was 28.6 ± 11.6 mm. The histological tumor types included GIST (n = 38), leiomyoma (n = 14), schwannoma (n = 6), early gastric cancer (n = 8) and others (n = 10). The surgical procedure consisted of classical LECS/CLEAN-NET/NEWS in 17/15/44 cases; all early gastric cancers were treated by NEWS. The mean length of postoperative hospital stay was 8.7 ± 3.9 days. The mean serum levels of C-reactive protein on POD1 and POD3 were 3.2 ± 1.9 and 4.4 ± 3.4 mg/dl, respectively. The postoperative complications were anastomotic stenosis (n = 1), delayed gastric emptying (n = 3), pneumonia (>Grade II by the Clavien-Dindo classification) (n = 1) and exacerbation of GERD (>Grade II by the Clavien-Dindo classification) (n = 3). In the patient group that developed complications, the postoperative resumption of water intake was later, and the postoperative hospital stay was longer as compared to the group without complications (p = 0.04, 0.028). No relationship was observed between the likelihood of development of complications and the tumor location. Conclusions: Use of minimally invasive surgical procedures such as LECS could minimize the extent of gastric resection without deformation, stenosis. We consider that for surgical complications the LECS approach can be employed, regardless of the tumor location.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Sign in / Sign up

Export Citation Format

Share Document