Previously operated recurrent pilonidal sinus treated with crystallized phenol: Twenty-year experience in a cohort study.

Objectives: Postoperative recurrent pilonidal sinus disease is troublesome, and its treatment is a challenge. In this study, it was aimed to present the long-term efficacy of crystallized phenol treatment on postoperative recurrent pilonidal sinus disease through our results collected within the last 20 years. Material and Methods: Two hundred and twenty-seven patients who had been previously operated on and suffered from recurrent pilonidal sinus disease were enrolled. The operation was applied in our outpatient clinic under local anesthesia. Demographic data of the patients, number of crystallized phenol treatment, duration of follow-up and recurrence numbers were prospectively recorded. Treatment success and factors affecting recurrence were examined. Results: Our success rate was found as 71.5%. This success rate belongs to the group of patients who never quit treatment and complied with the treatment. The patients were followed up for a mean 45.8 months. Of the post-crystallized phenol treatment recurrences, 72.4% took place within the first five years, while 97.4% did so within the first 10 years. Mean number of crystallized phenol applications was 2.6. The longer the duration of the disease before treatment, the more recurrence was observed after treatment (p= 0.02). There was no correlation between the number of previous operations and recurrence after treatment. As the number of sinus openings increased, so did the number of applications (p= 0.001). Conclusion: Crystallized phenol treatment yields promising long-term results in recurrent pilonidal sinus disease as well and may be recommended as the first choice in recurrent pilonidal sinus disease treatment since it is an effective non-operative treatment modality.

Long-term outcomes of crystallized phenol application for the treatment of pilonidal sinus disease.

OBJECTIVE: This study aimed to better demonstrate the long-term outcomes and effectiveness of crystallized phenol treatment (CPT) by presenting our 20 years experience. METHODS: One thousand and twenty-six patients who have primer pilonidal sinus were enrolled. The operation was applied outpatient clinic under local anesthesia. Recurrence rate, application number, healing time, and factors affecting them were analyzed. RESULTS: The success rate was 84.3%. The mean number of CPT applications was 2.1 and the mean recovery time was 8.9 weeks. The rate of recurrence was higher in patients with a long disease duration prior to initiating treatment (p = .04). The rate of recurrence was higher in patients with a higher number of opening and CPT application, those with longer application time, and those with a positive family history (respectively p = .01, p = .002, p = .008). CONCLUSIONS: Long-term outcomes are also very successful in the treatment of pilonidal disease with CPT. We believe that CPT should be the first choice in the treatment of pilonidal disease because it is inexpensive, can be applied as an outpatient treatment, is a noninvasive procedure, has results comparable to surgical procedures, and does not cause loss of work and strength.

Crystallized phenol for sacral hidradenitis suppurativa.

OBJECTIVE: Multiple treatment options for hidradenitis suppurativa (HS) have been suggested; none 100% successful. We assessed crystallized phenol treatment (CPT) for sacral HS. METHODS: Twenty-five patients with sacral HS were enrolled. HS severity was assessed by Hurley Score and HS-Physician's Global Assessment (HS-PGA). All the leaking openings were dilated by a thin mosquito clamp after local anesthesia. Any hair present was removed, and phenol was applied. RESULTS: Patients were followed-up for a mean 36.8 months. The mean number of CPT application was 3.98. After CPT mean Hurley score decreased from 2.1 ± 0.68 to 1.2 ± 0.4 and HS-PGA score from 3 ± 1.22 to 0.72 ± 8.4 (p = .01). Recurrence was seen in 10 patients during follow-up period but they were re-treated with CPT. CONCLUSION: CPT may be useful as a first-line treatment of sacral HS.

Predictive value of preoperative neutrophil-to-lymphocyte ratio while detecting bowel resection in hernia with intestinal incarceration.

BACKGROUND: The aim of this study was to evaluate the relationship between preoperative hematological inflammatory markers of the patients who underwent a surgery for incarcerated hernia and intestinal resection requirement. METHODS: The data of 102 patients who underwent a surgery for incarcerated hernia were retrospectively evaluated. Whole blood cell counts were preoperatively measured, and operation types and pathology results were recorded. The patients with intestinal resections were compared with those without any resection in terms of leukocyte number, neutrophil rate, red cell distribution width (RDW), platelet distribution width, neutrophil-to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV). RESULTS: Eighty-one patients were operated for incarcerated groin hernia, 17 for incarcerated umbilical hernia, and 4 for incarcerated incisional hernia. Twenty-six patients (25%) had intestinal resections; in 4 of them, intestinal perforation was detected. In patients with intestinal resections,the neutrophil rate, PDW, NLR, and PLR values were significantly higher than those in the patients without any resections. CONCLUSION: High NLR rates, certainly with clinical correlation, can be used as a biomarker to predict intestinal necrosis and the need for intestinal resection in patients who will undergo surgery for incarcerated hernia, particularlyin situations with lacking radiological imaging methods.