مقايسه شيوع عوارض پس از عمل جراحي به كمك فلپ ليمبرگ در بيماران مبتلا به آبسه پيلونيدال و سينوس پيلونيدال 1387-1390

Comparison between Prevalence of Complications after using Limberg Flap in Patients with Pilonidal Abcess and Patients with Pilonidal Sinus during 2008-2011

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﻋﻠﻴﺮﻏﻢ ﺗﮑﻨﻴﮏﻫﺎﻱ ﻣﺨﺘﻠﻒ ﺷﺮﺡ ﺩﺍﺩﻩ ﺷﺪﻩ ﺑﺮﺍﻱ ﺩﺭﻣﺎﻥ ﺑﻴﻤﺎﺭﻱ ﺳﻴﻨﻮﺱ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ، ﺟﺮﺍﺣﺎﻥ ﺩﺭ ﻣﻮﺭﺩ ﺭﻭﺵ ﺩﺭﻣﺎﻥ ﺁﺑﺴﻪ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﺑﺮ ﺭﻭﻱ ﺍﻧﺴﺰﻳﻮﻥ ﻭ ﺩﺭﻧﺎﮊ ﺍﻭﻟﻴﻪ ﺍﺗﻔﺎﻕ ﻧﻈﺮ ﺩﺍﺭﻧﺪ. ﻫﺪﻑ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺍﺭﺯﻳﺎﺑﻲ ﺑﻠﻨﺪ ﻣﺪﺕ ﺑﻴﻤﺎﺭﺍﻥ ﺑﺎ ﺁﺑﺴﻪ ﻭ ﺳﻴﻨﻮﺱ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﺍﺳﺖ ﮐﻪ ﺗﺤﺖ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﺭﺯﮐﺴﻴﻮﻥ ﻭ ﺗﺮﻣﻴﻢ ﺑﺎ ﻓﻠﭗ ﻟﻴﻤﺒﺮﮒ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪﺍﻧﺪ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﻲ ﺗﺤﻠﻴﻠﻲ 81 ﺑﻴﻤﺎﺭ ﻣﺒﺘﻼ ﺑﻪ ﺁﺑﺴﻪ ﻭ ﺳﻴﻨﻮﺱ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﺩﺭ ﻃﻲ ﺩﻭﺭﻩ ﺯﻣﺎﻧﻲ 3 ﺳﺎﻟﻪ ﺗﺤﺖ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﺭﺯﮐﺴﻴﻮﻥ ﻭ ﺗﺮﻣﻴﻢ ﻣﺤﻞ ﺑﺎ ﻓﻠﭗ ﻟﻴﻤﺒﺮﮒ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪﺍﻧﺪ. ﺩﺍﺩﻩﻫﺎ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺭﻭﺵﻫﺎﻱ ﺁﻣﺎﺭ ﺗﻮﺻﻴﻔﻲ ﻭ ﺁﺯﻣﻮﻥ ﮐﺎﻱ 2 ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ ﻭ ﺳﻄﺢ ﻣﻌﻨﻲﺩﺍﺭ ﺩﺭ ﺗﻤﺎﻣﻲ ﺁﺯﻣﻮﻥﻫﺎ ﻣﻘﺪﺍﺭ ﺍﺣﺘﻤﺎﻝ ﮐﻤﺘﺮ ﺍﺯ 0/05 ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺩﺭ ﻣﻴﺎﻥ ﺑﻴﻤﺎﺭﺍﻥ ﻣﻮﺭﺩ ﻣﻄﺎﻟﻌﻪ 21 ﻣﻮﺭﺩ ﻣﺒﺘﻼ ﺑﻪ ﺁﺑﺴﻪ ﻭ 60 ﻣﻮﺭﺩ ﺳﻴﻨﻮﺱ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﺑﻮﺩﻧﺪ. ﺍﺯ ﻣﻴﺎﻥ ﻋﻮﺍﺭﺽ ﺯﻭﺩﺭﺱ، ﻫﻤﺎﺗﻮﻡ ﺩﺭ ﺩﻭ ﺑﻴﻤﺎﺭ )2/4 ﻭ ﻋﻔﻮﻧﺖ ﻣﺤﻞ ﻋﻤﻞ ﺩﺭ 3 ﺑﻴﻤﺎﺭ ﮔﺮﻭﻩ ﺳﻴﻨﻮﺱ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﺑﺪﻭﻥ ﺁﺑﺴﻪ ﻭ 2 ﻣﻮﺭﺩ ﻋﻔﻮﻧﺖ ﺩﺭ ﮔﺮﻭﻩ ﺁﺑﺴﻪ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﻣﺸﺎﻫﺪﻩ ﺷﺪ. ﺑﻲﺣﺴﻲ ﺩﺭ ﻣﺤﻞ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﺑﻪ ﻋﻨﻮﺍﻥ ﺗﻨﻬﺎ ﻋﺎﺭﺿﻪ ﺑﻠﻨﺪ ﻣﺪﺕ ﺩﺭ 12 ﺑﻴﻤﺎﺭ ﮔﺮﻭﻩ ﺍﻭﻝ ﻭ 4 ﺑﻴﻤﺎﺭ ﮔﺮﻭﻩ ﺩﻭﻡ ﻳﺎﻓﺖ ﺷﺪ ﮐﻪ ﺷﻴﻮﻉ ﻋﻮﺍﺭﺽ ﺩﺭ ﺩﻭ ﮔﺮﻭﻩ ﻫﻴﭽﮕﻮﻧﻪ ﺍﺧﺘﻼف ﺁﻣﺎﺭﻱ ﻣﻌﻨﺎﺩﺍﺭﻱ ﻧﺪﺍﺷﺖ. ﻧﺘﻴﺠﻪﮔﻴـﺮﻱ: ﺍﻧﺠﺎﻡ ﺭﻭﺵ ﻓﻠﭗ ﻟﻴﻤﺒﺮﮒ ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﺑﺎ ﺁﺑﺴﻪ ﭘﻴﻠﻮﻧﻴﺪﺍﻝ ﺗﻔﺎﻭﺗﻲ ﺑﺎ ﺑﻴﻤﺎﺭﺍﻥ ﺑﺪﻭﻥ ﺁﺑﺴﻪ ﻧﺪﺍﺭﺩ.

Introduction & Objective: There is common view that the appropriate therapy for pilonidal abscess is simple incision and drainage. Our study aimed to investigate the surgical outcomes of limberg flap among patients with pilonidal abscess and its comparison with the cases of pilonidal sinus. Materials & Methods: We studied patients with pilonidal sinus and pilonidal abscess to evaluate the results of surgery, postoperative outcomes and further complications along with the recurrence rate. Hence, 81 patients were enrolled in our study from 2008 to 2011. All the patients were treated by limberg flap. Results: Of 81 patients with pilonidal disease, 60 patients had only sinus while 21 cases developed infected abscess. In the sinus group, 2 cases (2.4%) developed hematoma, 3 cases (5%) surgical site infections, and 12 (15%) surgical site numbness. In the abscess group, 2 of the cases (9.5%) had surgical site infection and 4 cases (19%) developed numbness. Conclusions: Performing Limberg flap procedure for the case of patients with pilonidal abscess leads to the same results as the case of patients with pilonidal sinus