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Karydakis flap reconstruction versus Limberg flap transposition for pilonidal sinus disease: a meta-analysis of randomized controlled trials

  • Systematic Reviews and Meta-analyses
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Introduction

The definitive treatment of pilonidal sinus disease (PSD) is surgical. There is still no consensus as to the most appropriate off-midline primary closure technique. The aim of this meta-analysis has been to compare Karydakis flap reconstruction (KF) to Limberg flap transposition (LF) with regard to short- and long-term postoperative outcomes.

Methods

A systematic literature search for randomized controlled trials (RCTs) comparing KF to LF was performed. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The odds ratio and standardized mean differences with 95% confidence intervals (CIs) were calculated.

Results

Eight RCTs were identified comparing KF (n = 554) to LF (n = 567). There was no significant difference noted between KF and LF with regard to the primary outcome variable, recurrence rate (OR = 1.07; 95% CI [0.59–1.92]; p = 0.83; 7 studies; I2 = 40%). LF was associated with a lower rate of post-operative seroma (OR = 2.03; 95% CI [1.15, 3.59]; p = 0.01; 7 studies; I2 = 0%). No further significant differences were noted in the secondary endpoints between the two study groups.

Conclusions

Recurrence rates of PSD were found to be similar in both study groups. Post-operative seroma rate was significantly higher in the KF group. The meta-analysis did not indicate any further statistically significant differences between the two surgical procedures.

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Authors and Affiliations

  1. Department of Surgery, Katholisches Klinikum Oberhausen, Nürnbergerstr. 10, 46117, Oberhausen, Germany

    Dimitrios Prassas, Thomas-Marten Rolfs & Franz-Josef Schumacher

  2. Department of Surgery, Düsseldorf University Hospital, Düsseldorf, Germany

    Andreas Krieg

Authors
  1. Dimitrios Prassas
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  2. Thomas-Marten Rolfs
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  3. Franz-Josef Schumacher
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  4. Andreas Krieg
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Contributions

D Prassas: study conception and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of manuscript. T-M Rolfs:, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of manuscript. F-J Schumacher: analysis and interpretation of data, drafting of manuscript, critical revision of manuscript. A Krieg: study conception and design, analysis and interpretation of data, drafting of manuscript, critical revision of manuscript.

Corresponding author

Correspondence to Dimitrios Prassas.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Research involving human participants

This article does not contain any studies with human participants or animal participants performed by any of the authors.

Informed consent

This was a review article, but to our knowledge, for all studies that were included, informed consent was obtained from all individual participants included in the study.

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Prassas, D., Rolfs, TM., Schumacher, FJ. et al. Karydakis flap reconstruction versus Limberg flap transposition for pilonidal sinus disease: a meta-analysis of randomized controlled trials. Langenbecks Arch Surg 403, 547–554 (2018). https://doi.org/10.1007/s00423-018-1697-7

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  • DOI: https://doi.org/10.1007/s00423-018-1697-7

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