scholarly journals Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study

2015 ◽  
Vol 100 (5) ◽  
pp. 870-877 ◽  
Author(s):  
Mehmet Tokac ◽  
Ersin Gurkan Dumlu ◽  
Murat Seyit Aydin ◽  
Abdussamed Yalcın ◽  
Mehmet Kilic
Keyword(s):  
Return To Work ◽  
Pilonidal Sinus ◽  
Randomized Study ◽  
Sitting Time ◽  
Long Term Results ◽  
Limberg Flap ◽  
Significant Difference ◽  
Modified Limberg Flap ◽  
Short And Long Term

The best surgical technique for pilonidal sinus disease (PSD) is still disputed. The objective of this prospective randomized study is to compare the short and long-term results of modified Limberg flap and Karydakis flap surgeries that have been widely used in recent years. Ninety one patients were included in the study. The patients were divided into two groups: modified Limberg flap (MLF; n = 46) and Karydakis flap (KF; n = 45). Preoperative findings of the patients, their surgical findings, and short and long-term postoperative findings were recorded and statistically compared. While no significant difference was discovered between the groups in terms of postoperative analgesic need, hospital stay, postoperative infection rate, drain stay time, painless sitting time, painless toilet-sitting time, and painless walking time, return to work or school time was shorter in the MLF group compared with the KF group (20.61 ± 7.89 days, 23.29 ± 6.42, respectively; P < 0.05). Cosmetically, the visual analog scale (VAS) of the KF group was significantly higher than that of the MLF group (VAS score 7.12 ± 1.28, 5.45 ± 1.77, respectively; P < 0.05). Considering recurrence rates, no statistically significant difference was found between the groups. Our study found out that short and long-term results of the MLF and KF procedures are similar. We believe both methods can be safely used in surgical PSD treatment given that in the MLF procedure, shorter return-to-work time is achieved, while the procedure provides better cosmetic results.

scholarly journals Retrospective Review of Pilonidal Sinus Patients With Early Discharge After Limberg Flap Procedure

2014 ◽  
Vol 99 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Fatih Altintoprak ◽  
Kemal Gundogdu ◽  
Tolga Ergonenc ◽  
Enis Dikicier ◽  
Guner Cakmak ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Early Discharge ◽  
Long Term Results ◽  
Limberg Flap ◽  
Flap Necrosis ◽  
Flap Procedure ◽  
Short And Long Term

Abstract The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6–72 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.

Retrograde thrombendarterectomy vs. ilio-femoral bypass in unilateral iliac TASC C and D lesions

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0211-0219 ◽  
Author(s):  
Ingolf Töpel ◽  
Matthias Wiesner ◽  
Christian Uhl ◽  
Thomas Betz ◽  
Markus G. Steinbauer
Keyword(s):  
Graft Infection ◽  
External Iliac Artery ◽  
Prosthetic Graft ◽  
Long Term Results ◽  
Local Conditions ◽  
Prosthetic Graft Infection ◽  
Significant Difference ◽  
Short And Long Term

Background: To compare short and long term results of retrograde Thrombendarterectomy (rTEA) and ilio-femoral Bypass (IFBP) to treat iliac TASC C and D lesions. Patients and methods: Retrospective analysis of 108 patients treated at a single vascular center by either rTEA (n = 42) or IFBP (n = 66) over a period of 4 years. Results: Both methods did not significantly differ in 30-day (rTEA 0 % vs IFBP 2 %) or long-term mortality (rTEA 24 % vs IFBP 30 % at 4 years) with a median follow-up of 46 months. There were no procedure related deaths. Patency was similar for both groups (rTEA 93 % vs IFBP 98 % at 30 days; rTEA 83 % vs 92 % IFBP at 4 years). We could not find a significant difference in limb salvage rates (rTEA 93 % vs IFBP 100 % at 30 days and at 4 years). The incidence of prolonged lymphorrhea was significantly higher in the IFBP group (rTEA 0 % vs IFBP 21 %). In 4 IFBP patients a prosthetic graft infection occurred. Conclusions: Regarding short and long term results operative procedures as rTEA and IFBP still represent the gold standard in the treatment of TASC C and D lesions of the external iliac artery especially in patients with additional lesions in the common femoral and profundal femoral artery. Taking into account certain anatomical characteristics (heavily calcified lesions, narrow external iliac arteries or very tortuous iliac segments) and individual local conditions (prior vascular procedures involving the femoral bifurcation) the single incision retrograde approach to the EIA with rTEA may have advantages over IFBP, especially concerning postoperative complications like lymphorrhea and graft infection.

scholarly journals Pilonidal sinus- limberg versus karidakis flap our experience at SIMS, Shivamogga

2017 ◽  
Vol 4 (11) ◽  
pp. 3641
Author(s):  
Madhusudhan A. ◽  
Madhan D. P. Swamy ◽  
Mohhamad Arif
Keyword(s):  
Pilonidal Sinus ◽  
Long Term Results ◽  
Pilonidal Sinus Disease ◽  
Surgical Removal ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Number Of Patients ◽  
Successful Recovery ◽  
Surgical Methods

Background: The etiology and pathogenesis of sacro-coccygeal pilonidal sinus are not clear. The pathogenesis of the disease is hypothesized to be related to the accumulation of weak and lifeless hair in the intergluteal region, which over time gives rise to foreign body reaction, causing abscess and sinus formation. A deep natal cleft with one of favourable factors enhance sacro-coccygeal pilonidal sinus, e.g., sweating, maceration, bacterial contamination and penetration of hairs. Obesity, trauma, local irritation and a sedentary lifestyle are usually associated with PS. Although pilonidal sinus can be treated using various conservative and surgical methods, recurrence rate remains high. Complete surgical removal of the pilonidal sinus or sinuses and appropriate reconstruction can lead to successful recovery. However, collection of the lifeless hair depends on the anatomy of the intergluteal area, and accompanying risk factors can lead to subsequent recurrence.Methods: The objective of this study is to compare the immediate post-operative and long-term results of Limberg flap and Karydakis flap, which are being widely used now to treat pilonidal sinus disease. It was a retrospective observational study where the patients (total number of patients-30) who underwent both the procedures were compared, Limberg flap (LF; n = 13) and Karydakis flap (KF; n = 17).Results: Present study found out that short and long-term results of the LF and KF procedures are similar. In present study we also noted that all patients with pilonidal sinus disease were men, and most of them had jobs which involved sitting for long durations. Poor hygiene and hirsutism however was not noted in most of the patients, and was not objectively assessed.Conclusions: Both the techniques can be used safely and effectively in sacro coccygeal pilonidal sinus disease.

scholarly journals Pilonidal Sinus—Plenty of Literature yet Lack of Direction: A Pooled Analysis

2019 ◽  
Vol 103 (9-10) ◽  
pp. 443-451
Author(s):  
Jemma K. Porrett ◽  
Liesel J. Porrett ◽  
Yik-Hong Ho ◽  
Warren M. Rozen
Keyword(s):  
Surgical Treatment ◽  
Outcome Measures ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Treatment Modalities ◽  
Secondary Outcome ◽  
Limberg Flap ◽  
Secondary Intention ◽  
Significant Difference ◽  
Modified Limberg Flap

A systematic analysis was conducted to compare various surgical treatment modalities and evaluate the short- and long-term outcomes in the management of sacrococcygeal pilonidal disease. Pilonidal sinus is a common and debilitating condition often requiring a surgical approach to treatment, of which many are available. Despite numerous treatment methods, no universal decision has been made as to the most efficient and effective surgical treatment. All randomized control trials published between January 1, 2003 and January 8, 2013 were accessed. Interventions included classic and modified Limberg flap, Karydakis flap, primary closure, and healing by secondary intention. Primary outcome measures included rate of surgical site infection, recurrence, and length of hospital stay. Secondary outcome measures were hematoma or seroma, and return to work. The search identified 22 articles suitable for inclusion in this review totaling 3693 patients. Analysis showed a 50% reduction in the rate of infection and recurrence in patients receiving closure with flaps compared with primary midline closure and healing by secondary intention. The Karydakis flap was shown to be more favorable cosmetically; however, it failed to compete with the classic and modified Limberg flap in treatment of complicated disease. No significant difference was noted between the modified Limberg and Limberg flap. These results show that the Karydakis flap, classic, and modified Limberg flap demonstrate significant benefits over healing by secondary intention and primary closure.

Long-Term Results of Limberg Flap Procedure for Treatment of Pilonidal Sinus

2003 ◽  
Vol 46 (11) ◽  
pp. 1545-1548 ◽  
Author(s):  
Koray Topgül ◽  
Ersin Özdemir ◽  
Kadir Kiliç ◽  
Hakan Gökbayir ◽  
Zafer Ferahköşe
Keyword(s):  
Pilonidal Sinus ◽  
Long Term Results ◽  
Limberg Flap ◽  
Flap Procedure

scholarly journals Comparative analysis of conventional and eversion carotid endarterectomy: Prospective randomized study

2008 ◽  
Vol 136 (11-12) ◽  
pp. 590-597 ◽  
Author(s):  
Dragan Markovic ◽  
Lazar Davidovic ◽  
Zivan Maksimovic ◽  
Ilija Kuzmanovic ◽  
Nikola Ilic
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Randomized Study ◽  
Neurological Complications ◽  
Long Term Results ◽  
Eversion Endarterectomy ◽  
Significant Difference

INTRODUCTION Studies completed in the last decade of the 20th century showed benefits of carotid endarterectomy in the prevention of stroke in patients with a high-grade stenosis of the internal carotid artery. OBJECTIVE The aim of this prospective, randomized study was the comparison of early and long-term results between the conventional and eversion carotid endarterectomy, and literature review. METHOD By the method of random choice, 103 patients were operated on using the eversion carotid endarterectomy and 98 patients using the conventional technique. Operative treatment was carried out under general anaesthesia. Following the clammping of the carotid artery, retrograde blood pressure was determined by a direct puncture of the internal carotid artery above the stenotic lesions. In patients with retrograde pressure below 20 mm Hg intraluminal shunting was routinely performed. Early results were estimated (during the first seven postoperative days) based on mortality, central neurological complications (stroke, TIA) and cranial or cervical nerve lesions. Long-term results were estimated (after at least two years) based on long-term survival rate, central neurological complications (stroke, TIA) and the incidence of haemodynamically significant restenosis of the carotid artery treated by endarterectomy. RESULTS The average time of clamming of the internal carotid artery in the eversion carotid anderectomy group was 5.36 minutes shorter than in the group treated by the conventional technique. Student's t-test showed a statistically highly significant difference in the time needed for clamming of the internal carotid artery between the two groups. The average duration of eversion endarterectomy (82 minutes) was most often 19 minutes shorter than the duration of the conventional endarterectomy (101 minutes). Student's t-test showed a statistically highly significant difference in the average length of surgeries. The distal intimal fixation was more often needed during the conventional carotid endarterectomy (34.7%) compared to eversion endarterectomy (3.9%). ?2-test showed a statistically highly significant difference. CONCLUSION Eversion carotid endarectomy represents a statistically significantly shorter procedure. Distal intimal fixation demanded by this procedure is very rare, clammping of the internal carotid artery is significantly shorter, and it also has a lower rate of the early neurological complications. Based on the results of this study, as well as the opinions of other authors, it can be concluded that the eversion carotid endarterectomy has an advantage over the conventional procedure. We recommend conventional procedure only in cases when retrograde pressure indicates the use of the intraluminal shunting.

A Comparison of the Results of the Karydakis Flap Procedure and Primary Closure in the Treatment of Pilonidal Sinus Disease Over the Short and Long Term: A Randomized Clinical Study

2016 ◽  
Vol 101 (11-12) ◽  
pp. 503-509
Author(s):  
Murat Kendirci ◽  
Tezcan Akin ◽  
Merve Akin ◽  
Hüseyin Berkem ◽  
Süleyman Hengirmen ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Long Term Results ◽  
Pilonidal Sinus Disease ◽  
Flap Procedure ◽  
Short And Long Term ◽  
Group 2 ◽  
Duration Of Operation ◽  
Group 1

In the current prospective study, we compared the results of the Karydakis flap procedure (KFP) and primary closure (PC). This study compared the short and long-term results of the KFP and PC techniques. The sample of this study was a total of 352 patients (302 male: 85.7%; median age: 24 years) who underwent reconstruction after pilonidal sinus excision in our clinic. The reconstruction was performed using the KFP (group 1, n = 176, 50%) or PC (group 2, n = 176, 50%). The following data on the patients was obtained; sex, age, body mass index (BMI), duration of operation and hospital stay, length of time patient could walk without pain, length of time patients could sit on toilet without pain, complications (e.g., infection, recurrence). No significant difference was found between groups 1 and 2 with respect to sex, age, BMI, and duration of operation. Moreover, length of time patients could walk and sit on toilet without pain was similar in both groups. On the other hand, the rate of recurrence was significantly lower in group 1 (n = 4, 2%) compared with group 2 (n = 20, 11%, P < 0.001). KFP is preferable to PC since it is easier to learn and perform and has lower complication and recurrence rates.

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