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.

scholarly journals Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery

2018 ◽  
Vol 119 (4) ◽  
pp. 148-155 ◽  
Author(s):  
Abdulcabbar Kartal ◽  
Hüseyin Onur Aydın ◽  
Mehmet Oduncu ◽  
Murat Ferhat Ferhatoğlu ◽  
Taner Kıvılcım ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Transposition Flap ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods.

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.

Muzi's Tension Free Primary Closure of Pilonidal Sinus Disease: Long-Term Results on 450 Patients

2017 ◽  
Vol 152 (5) ◽  
pp. S1212-S1213 ◽  
Author(s):  
Marco Gallinella Muzi ◽  
Claudia Mosconi ◽  
Marco Colella ◽  
Agnese Cianfarani ◽  
Pietro Mascagni ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Long Term Results ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Tension Free

Muzi’s Tension Free Primary Closure of Pilonidal Sinus Disease: Updates on Long-Term Results on 514 Patients

2017 ◽  
Vol 22 (1) ◽  
pp. 133-137 ◽  
Author(s):  
Marco Gallinella Muzi ◽  
Pietro Mascagni ◽  
Oreste Buonomo ◽  
Agnese Cianfarani ◽  
Claudia Mosconi ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Long Term Results ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Tension Free

scholarly journals A Prospective Controlled Study on Long-Term Outcomes of Facial Lacerations in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Sonja Fontana ◽  
Clemens M. Schiestl ◽  
Markus A. Landolt ◽  
Georg Staubli ◽  
Sara von Salis ◽  
...  
Keyword(s):  
Treatment Time ◽  
Trial Registration ◽  
Long Term Results ◽  
Controlled Study ◽  
Tissue Adhesives ◽  
Scar Assessment ◽  
Group 2 ◽  
Group 1

Background: Although skin adhesives have been used for decades to treat skin lacerations, uncertainty remains about long-term results, and complications.Methods: In this prospective, controlled, single-blinded, observational cohort study, outcomes were assessed by five plastic surgeons with standardized photographs at 6–12 months using a modified Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS); additionally, the POSAS was performed by the patients/caregivers and the physician; pain, requirement of anesthesia, treatment time, costs, complications, and quality of live (QoL) were assessed.Results: A total of 367 patients were enrolled; 230 were included in the main analysis; 96 wounds were closed using tissue adhesives (group 1); 134 were sutured (group 2). Assessment by the independent observers revealed an improved mean modified overall POSAS score in group 1 in comparison with group 2 [2.1, 95% CI [1.97–2.25] vs. 2.5, 95% CI [2.39–2.63]; p &lt; 0.001, d = 0.58] and mean VSS score [1.2, 95% CI [0.981–1.34] vs. 1.6, 95% CI [1.49–1.79], p &lt; 0.001, d = 0.53]. At the early follow-up, dehiscence rate was 12.5% in group 1 and 3.7% in group 2 (p &lt; 0.001); later on, one dehiscence remained per group. Mild impairment of QoL was found at the early follow-up in both groups, with no impairment remaining later on. Duration of treatment and treatment costs were lower in group 1.Conclusion: Both modalities of wound closure yield favorable esthetic results, and complications are rare. Adhesives are more cost-effective, and its application is less time-consuming; therefore, tissue adhesives offer considerable advantages when used appropriately.Trial Registration: Public trial registration was performed at www.ClinicalTrials.gov (Identifier: NCT03080467).

scholarly journals Immediate and long-term results of carotid endarterectomy in different periods of ischemic stroke

2020 ◽  
Vol 28 (3) ◽  
pp. 312-322
Author(s):  
Anton N. Kazantsev ◽  
Konstantin P. Chernykh ◽  
Nona E. Zarkua ◽  
Roman Yu. Lider ◽  
Ekaterina A. Burkova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Long Term Results ◽  
Lethal Outcome ◽  
Group 4 ◽  
Hospitalization Period ◽  
Rehabilitation Period ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. Analysis of hospital and long-term results of carotid endarterectomy (CEA) in different periods of acute cerebrovascular event (ACVE). Materials and Methods. The given study was retrospective and was conducted using the method of patients sampling. In the period from 2010 to 2019, 1113 patients with ACVE in history who were later conducted CEA, were selected. Depending on the time interval between the last ACVE and CAE, all the patients were divided into 4 groups: the 1st group in the acutest period of ACVE (1-3 days) (n=24; 2.2%); the 2nd group in the acute period of ACVE (up to 28 days) (n=493; 44.3%); the 3rd group in the early rehabilitation period of ACVE (up to 6 months) (n=481; 43.2%); the 4th group in the late rehabilitation period of ACVE (up to 2 years) (n=115; 10.3%). The long-term period was 34.812.5 months. Results. In the hospitalization period of observation the following complications were found: lethal outcome ((group 1 0%; group 2 0.4% (n=2); group 3 0.2% (n=1); group 4 0%; р=0.16)); myocardial infarction ((group 1 0%; group 2 0.4% (n=2); group 3 0%; group 4 0.9% (n=1); р=0.35)); ACVE/transient ischemic attack (TIA), ((group 1 4.2% (n=1); group 2 0.4% (n=2); group 3 0.2% (n=1); group 4 0%; р1-2=0.01; р1-3=0.009; р1-4=0.01)). By the end of hospitalization period the composite endpoint consisting of lethal outcome + myocardial infarction + ACVE/TIA made in group 1 4.2% (n=1), in group 2 1.2% (n=6), in group 3 0.4% (n=2), in group 4 2.6% (n=3), р=0.08. Complications of the long-term follow-up period were: lethal outcome from all causes ((group 1 25% (n=6); group 2 5.5% (n=27); group 3 7.3% (n=35); group 4 14% (n=16); р1-2=0.002; р1-3=0.008; р2-4=0.012)); lethal outcome from cardiovascular causes ((group 1 4.2% (n=1); group 2 3.6% (n=18); group 3 4.8% (n=23); group 4 5.2% (n=6); р=0.79)), myocardial infarction ((group 1 12.5% (n=3); group 2 3.6% (n=18); group 3 5.4% (n=26); group 4 6.1% (n=7); р=0.15)), ACVE/TIA ((group 1 16.6% (n=4); group 2 6.3% (n=31); group 3 6% (n=29); group 4 11.3% (n=13); р=0.05)); composite endpoint including lethal outcome + myocardial infarction + ACVE/TIA ((group 1 54.2% (n=13); group 2 15.4% (n=76); group 3 18.7% (n=90); group 4 31.3% (n=36); р1-2=0.0001; р1-3=0.0001; р1-4=0.005; р2-4=0.0006; р3-4=0.012)). Conclusion. Application of CEA demonstrated effectiveness and safety in the acute and early rehabilitation period of ACVE.

scholarly journals Long-term results of surgical treatment of thyroid adenomas

2019 ◽  
Vol 100 (6) ◽  
pp. 892-897
Author(s):  
Stanislav Olegovich Artyukhin ◽  
Vladimir Georgievich Aristarhov ◽  
Denis Anatolyevich Puzin
Keyword(s):  
Surgical Treatment ◽  
Needle Aspiration ◽  
Long Term Results ◽  
Fine Needle ◽  
Thyroid Adenomas ◽  
Follicular Tumor ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To study the long-term results of surgical treatment of patients with thyroid adenomas. Methods. From 2004 to 2006, 667 patients with follicular adenomas of the thyroid gland, including 134 (20.1%) men and 533 (79.9%) women, were operated on in the surgical department №2 of city clinical hospital №11 of Ryazan. 3 groups of patients were defined: group 1 operated on for solitary adenomas of the thyroid gland, 103 patients, hemithyreoidectomy performed; group 2 operated on for multiple adenomas of the thyroid in both lobes, 101 patients, thyroidectomy performed; group 3 32 patients operated on for multiple adenomas of the thyroid in the same lobe, hemithyreoidectomy performed. Patients were examined 14 years after the surgery. Results. Hypothyroidism was diagnosed in: group 1 18 (17.5%) patients, group 2 101 (100%), group 3 0. All patients with hypothyroidism were compensated with hormone replacement therapy. Permanent hypoparathyroidism was diagnosed only in group 2 8 (4.8%) patients. Unilateral laryngeal paralysis was found in group 1 in 1 (0.9%) patient, group 2 in 2 (1.9%) patients, group 3 contained no such patients. Recurrence (node more than 1 cm according to ultrasound) was observed in group 1 in 12 (11.7%) patients; fine-needle aspiration found colloidal nodes in 8 (7.8%) patients (Bethesda II), in 4 (3.9%) follicular tumor (IV). Group 2 had no recurrences. In group 3 11 (34.3%) patients had recurrence; fine-needle aspiration found colloidal nodes in 1 (3.1%) patient (Bethesda II), in 10 (31.3%) follicular tumor (Bethesda IV). Conclusion. In solitary adenomas it is possible to perform organ-saving operations, which reduces the percentage of postoperative complications; in multiple adenomas, the optimal volume of surgery is thyroidectomy; when multiple adenomas are localized in one lobe, the chance of recurrence of the disease (31.3%) is high leading to re-surgery.

Abstract 13347: Effect of Severe Anemia (hemoglobin < 10g/dl) on Short- and Long-term Outcome in Acute Coronary Syndrome: Insights of a Terciary Centre

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Isabel Campos ◽  
Cátia Oliveira ◽  
Paulo Medeiros ◽  
Carla Marques Pires ◽  
Rui Flores ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Morbidity And Mortality ◽  
Severe Anemia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Short And Long Term ◽  
Group 2 ◽  
Group 1

Introduction: Although invasive strategies are the generalized approach in the management of ACS pts, their benefits in pts with significant anemia are unclear, as anemia is strongly associated with increased risk of morbidity and mortality. Aim: To determine the incidence and the impact of severe anemia (hemoglobin<10g/dL) on short- and long-term outcome in pts hospitalized with ACS. Methods: We analyzed retrospectively 2905 ACSpts admitted for 6 years in our CCU. Pts were divided into two groups: group 1-pts with severe anemia(hemoglobin < 10g/dL) (n=257,8.8%); group 2-pts without severe anemia (hemoglobin >=10g/dL) (n=2648,91.2%). Primary endpoint was the occurrence of a composite of death and adverse cardiovascular events (stroke, reinfarction, and rehospitalization of cardiovascular etiology) at 6 months; FU was completed in 96%pts. Results: The sample consisted in 77.9% men and 22.1% women, with mean age of 64±13 years. The incidence of severe anemia was 8.8%. Group1 pts were older (p<0.001), had a higher proportion of women (p<0.001), diabetes (p<0.001), CKD (p<0.001) and AF (p<0.001). During hospitalization, group 1 had more HF (p<0.001), angor (p<0.001), refarction (p=0.006), bleeding (p<0.001) and transfusion (p<0.001). Group 1 had a higher proportion of NSTEMI (p=0.009) as opposed to group2 which had more STEMI (p=0.031). During hospitalization, group 2 pts were more likely to undergo revascularization (p<0.001). A multivariate analysis identified age [OR 1.06, 95%CI 1.04 to 1.07; p<0.001] and feminine sex [OR 2.61, 95%CI 1.89 to 3.61; p<0.001] as independent predictors of severe anemia during hospitalization. Pts with severe anemia had higher 6-month mortality (32.1%vs6.9%;p<0.001). In multivariate analysis and after adjusting for different baseline characteristics, pts with severe anemia had higher occurrence of a composite of death and MACE at 6months [OR5.04,95%CI 1.21 to 21.04;p=0.026]. Conclusion: Severe anemia was strongly associated with increased risk of morbidity and mortality in ACS pts. However, pts with severe anemia who were double antiaggregated had no worse outcomes than those who had simple antiaggregation after 6months. Therefore, there was no significant difference regarding revascularization in these pts.

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