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Der Chirurg

, Volume 86, Issue 5, pp 482–485 | Cite as

„Pit-picking“-Operation bei Patienten mit Sinus pilonidalis

Mittelfristige Ergebnisse und Risikofaktoren
  • I. IesalnieksEmail author
  • S. Deimel
  • H.J. Schlitt
Originalien

Zusammenfassung

Einleitung

Minimal-invasive Operationen für die Behandlung des Sinus pilonidalis gewinnen eine zunehmende Verbreitung, allerdings sind die mittel- und die langfristigen Ergebnisse noch unzureichend erforscht.

Patienten und Methoden

Bei allen Patienten dieser Analyse wurde ambulant die sog. „Pit-picking“-Operation durchgeführt. Die Primärfistel in der Rima ani wird dabei in Lokalanästhesie mit einem max. 1 mm großen Hautsaum sparsam exzidiert. Im Bereich des subkutanen Sinus (meist an der Stelle früherer Abszedierung) wird eine etwa 1 cm große Gegeninzision gesetzt. Eine Nachbehandlung ist nicht notwendig.

Ergebnisse

Zwischen 06/2007 und 11/2010 wurde bei 153 Patienten eine „Pit-picking“-Operation (126 m, 27 w) durchgeführt. Die Nachsorgezeit betrug median 30 Monate, 148 Patienten konnten nachuntersucht werden (97 %) vor. 74 % der Patienten blieben ohne Rezidiv, weitere 8 Patienten (5 %) blieben rezidivfrei nach einer zweiten „Pit-picking“-Operation. In der multivariaten Analyse waren Rauchen (Hazard Ratio 2,1) und Pilonidalabszess in der Anamnese (Hazard Ratio 2,7) statistisch signifikant mit einem erhöhten Rezidivrisiko assoziiert.

Schlussfolgerung

Etwa drei Viertel der ausgewählten Patienten profitieren mittelfristig von der „Pit-picking“-Operation bei Sinus pilonidalis.

Schlüsselwörter

Sinus pilonidalis Minimal-invasive Operation Pit picking Rezidive Nachsorgezeit 

“Pit picking” surgery for patients with pilonidal disease

Mid-term results and risk factors

Abstract

Background

Minimally invasive procedures have increasingly been used to treat pilonidal disease; however, the mid-term and long-term results have not been evaluated extensively yet.

Patients and methods

All patients underwent “pit picking” surgery. The surgery was performed under local anesthesia. The technique of “pit picking” was: all midline pits were removed by excising a margin of skin of < 1 mm. An incision of 1 cm parallel to one side of the natal cleft opened the chronic abscess cavity. No specific postoperative wound care was given.

Results

A total of 153 patients (126 males) underwent “pit picking” surgery between June 2007 and November 2010. Follow-up information was available for 148 patients (97 %). Of the patients 74% had no recurrence after a median follow-up time of 30 months and 8 more patients (5 %) remained asymptomatic after a second“pit picking” procedure. By multivariate analysis, smoking (hazard ratio [HR] 2.1) and occurrence of an abscess during the course of disease (HR 2.7) were statistically significantly associated with the disease recurrence after “pit picking” surgery.

Conclusion

Approximately three quarters of selected patients with pilonidal disease benefit from minimally invasive “pit picking” surgery.

Keywords

Pilonidal disease Minimally invasive surgery Pit picking Recurrence Follow up period 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. I. Iesalnieks, S. Deimel und H.J. Schlitt geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Klinik für Allgemein- und ViszeralchirurgieMarienhospital GelsenkirchenGelsenkirchenDeutschland
  2. 2.Klinik und Poliklinik für ChirurgieUniversitätsklinikum RegensburgRegensburgDeutschland
  3. 3.Klinik für Allgemein- und ViszeralchirurgieStädtisches Klinikum Bogenhausen MünchenMünchenDeutschland

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