RESUMEN
BACKGROUND: Optimal surgical treatment for pilonidal sinus disease remains controversial. Studies in children are uncommon with overall high postoperative recurrence and infection rates (20%). Our unit adopted a technique for excision of the pilonidal sinus with primary midline closure using a full-thickness flap. We present our results of this technique in the pediatric age group. METHODS: Single-center retrospective review and telephone follow-up was performed, including all children undergoing pilonidal sinus excision from 2005 to 2014 using the same operative technique and preoperative/postoperative care. RESULTS: 19 children were identified. Median age was 15years, and 47% were male. All had previously infected sinuses, with 5 requiring abscess drainage. Median follow-up was 13months (3.5-67months). Histology confirmed pilonidal sinus in 18/19 cases (one developmental malformation excluded from subsequent analysis). Recurrence requiring further surgery occurred in 4/18 (22%) patients at a median of 9months (range 8-36), wound dehiscence in 8/18 (44%), and wound infection in 5/18 (28%) cases. Laser hair removal of the natal cleft was performed in 7/18 (39%) patients with no further recurrence. CONCLUSION: This is the first report of this technique in children which showed a higher incidence of complications than a comparable adult study. Our study underlines the importance of accurate long-term outcomes when introducing new techniques to evaluate operation-associated morbidity. Our preliminary results of laser hair removal are promising but need to be evaluated with a prospective study.
Asunto(s)
Seno Pilonidal/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Adolescente , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Complicaciones Posoperatorias/epidemiología , Recurrencia , Estudios Retrospectivos , Resultado del TratamientoAsunto(s)
Antiinflamatorios/efectos adversos , Anticuerpos Monoclonales/efectos adversos , Encefalopatías/inducido químicamente , Enfermedad de Crohn/tratamiento farmacológico , Dolor Abdominal , Adolescente , Azatioprina/uso terapéutico , Encefalopatías/diagnóstico , Colectomía , Colonoscopía , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/cirugía , Diarrea , Fisura Anal/diagnóstico , Fisura Anal/tratamiento farmacológico , Humanos , Ileostomía , Infliximab , Imagen por Resonancia Magnética , Masculino , Prednisolona/uso terapéutico , Convulsiones/inducido químicamente , Síndrome , Trastornos de la Visión/inducido químicamenteAsunto(s)
Colectomía , Enfermedad de Crohn/complicaciones , Neumonía/diagnóstico , Neumonía/etiología , Antiinflamatorios/administración & dosificación , Azatioprina/administración & dosificación , Biopsia , Preescolar , Colectomía/efectos adversos , Tos/etiología , Enfermedad de Crohn/tratamiento farmacológico , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Inmunosupresores/administración & dosificación , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Neumonía/tratamiento farmacológico , Prednisolona/administración & dosificación , Respiración/efectos de los fármacos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Pérdida de PesoRESUMEN
The procedures reviewed in this article comprised 83 PEG insertions and 39 PEG changes in children aged six weeks to 19 years (median three years) with weights between 4.7 kg and 80 kg (median 13.5 kg). The complication rate was lower than previously reported paediatric series performed exclusively by medical practitioners. Four children required open conversion and one gastro-colic fistula was discovered five months later.
