Abstract
Purpose
Pilonidal sinus disease (PSD) is usually seen on the sacrococcygeal region in adolescent patients. The current study analyzed the outcome of the rhomboid excision and the Limberg flap procedure (cLF) in comparison to the modified Limberg flap procedure (mlF) for PSD.
Methods
Four hundred and sixteen patients with PSD were operated on under spinal or general anesthesia by cLF and mlF. The patients were divided into two groups. In Group 1, cLF was performed on 211 patients. In Group 2, mlF was performed on 205 patients.
Results
No significant difference was detected between Groups 1 and 2 in terms of sex, age, preoperative disease period, follow-up time, the mean hospital stay, and hypoesthesia. The mlF group had better clinical results than the cLF group. The recurrence rate was statistically higher in the cLF group 1 than in the mlF group (P = 0.036). The time to return to work, time to walk without pain, and time to be able to sit on the toilet without pain were longer in the cLF group (P = 0.001). The maceration and wound infection rate were statistically higher in the cLF group than in the mlF group (P = 0.020 and P = 0.019, respectively).
Conclusion
The mlF is a more effective treatment than cLF for the surgical management of PSD.
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References
Chintapatla S, Safarani N, Kumar S, Haboubi N. Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol 2003;7:3–8.
Mentes O, Bagci M, Bilgin T, Ozgul O, Ozdemir M. Limberg flap procedure for pilonidal sinus disease: results of 353 patients. Langenbecks Arch Surg 2007;393:185–189.
Grant I, Mahaffey PJ. Pilonidal sinus of the finger pulp. J Hand Surg 2001;26:490–491.
Val-Bernal JF, Azcarretazabal T, Garijio MF. Pilonidal sinus of the penis. A report of two cases, one of them associated with actinomycosis. J Cutan Pathol 1999;26:155–158.
Topgul K, Ozdemir E, Kilic K, Gokbayir H, Ferahkose Z. Longterm results of Limberg flap procedure for treatment of pilonidal sinus: a report of 200 cases. Dis Colon Rectum 2003;46:1545–1548.
Rabie ME, Al Refeidi AA, Al Haizaee A, Hilal S, Al Ajmi H, Al Amri AA. Sacrococcygeal pilonidal disease: sinotomy versus excisional surgery, a retrospective study. Aust N Z J Surg 2007;77:177–180.
Mentes BB, Leventoglu S, Cihan A, Tatlicioglu E, Akin M, Oguz M. Modified Limberg transposition flap for sacrococcygeal pilonidal sinus. Surg Today 2004:34:419–423.
Fuzun M, Bakır H, Soylu M, Tansug T, Kaymak E, Harmancıoglu O. Which technique for treatment of pilonidal sinus-open or closed? Dis Colon Rectum 1994;37:1148–1150.
Solla JA, Rothenberger DA. Chronic pilonidal disease. An assessment of 150 cases. Dis Colon Rectum 1990;33:758–761.
Monterola C, Barroso M, Araya JC, Fonseca L. Pilonidal disease: 25 cases treated by Dufourmentel technique. Dis Colon Rectum 1991;8:649–652.
Mentes O, Bagci M, Bilgin T, Coskun I, Ozgul O, Ozdemir M. Management of pilonidal sinus disease with oblique excision and primary closure: Result of 493 patients. Dis Colon Rectum 2005;49:104–108.
Petersen S, Koch R, Stelzner S, Wendlandt T-P, Ludwig K. Primary closure techniques in chronic pilonidal sinus. A survey of the results of different surgical approaches. Dis Colon Rectum 2002;43:700–706.
Cihan A, Ucan BH, Comert M, Cesur A, Cakmak GK, Tascilar O. Superiority of asymmetric modified Limberg flap for surgical treatment of pilonidal disease. Dis Colon Rectum 2005;49:244–249.
Tekin A. A simple modification with the Limberg flap for chronic pilonidal disease. Surgery 2005;138:951–953.
Fazeli MS, Adel MG, Lebaschi AH. Comparison of outcomes in Z-plasty and delayed healing by secondary intention of the wound after excision of the sacral pilonidal sinus: results of a randomized, clinical trial. Dis Colon Rectum 2006;49:1831–1836.
Akinci OF, Bozer M, Uzunkoy A, Duzgun SA, Coskun A. Incidence and aetiological factors in pilonidal sinus among Turkish soldiers. Eur J Surg 1999:165;339–342.
Sondenaa K, Nesvik I, Andersen E, Soreide JA. Recurrent pilonidal sinus after excision with closed or open treatment: final result of a randomized trial. Eur J Surg 1996;162:237–240.
Bisset IP, Isbister WH. The management patients with pilonidal disease-a comparative study. Aust N Z J Surg 1987;57:939–942.
Tezel E. A new classification according to navicular area concept for sacrococcygeal pilonidal disease. Colorectal Dis 2007;9:575–576.
da Silva JH. Pilonidal cyst: cause and treatment. Dis Colon Rectum 2000;43:1146–1156.
Eryilmaz R, Sahin M, Alimoglu O, Dasiran F. Surgical treatment of sacrococcygeal pilonidal sinus with the Limberg transposition flap. Surgery 2003;134:745–749.
Boscom JU. Pilonidal sinus. Curr Pract Surg 1994;6:175–180.
Senapati A, Cripps NPJ, Thompson MR. Bascom’s operation in the day-surgical management of symptomatic pilonidal sinus. Br J Surg 2000;87:1067–1070.
Ertan T, Koc M, Gocmen E, Aslar K, Keksek M, Kilic M. Does technique alter quality of life after pilonidal sinus surgery? Am J Surg 2005;190:388–392.
Akin M, Gokbayir H, Kilic K, Topgul K, Ozdemir E, Ferahkose Z. Rhomboid excision and Limberg flap for managing pilonidal sinus: long-term results of 411 cases. Colorectal Dis 2008;10:945–948.
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Akin, M., Leventoglu, S., Mentes, B.B. et al. Comparison of the classic limberg flap and modified limberg flap in the treatment of pilonidal sinus disease: A retrospective analysis of 416 patients. Surg Today 40, 757–762 (2010). https://doi.org/10.1007/s00595-008-4098-7
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DOI: https://doi.org/10.1007/s00595-008-4098-7