MODIFIED KARYDAKIS TECHIQUE FOR SINUS PILONIDAL DISEASE; MANISA STATE HOSPITAL EXPERIENCE. Pilonidal sinüs hastal???nda modifiye Karydakis operasyonu; Manisa Devlet Hastanesi deneyimi.

摘要

In this study, we aimed to investigate the effectiveness of our modifications of original Karydakis repair in pilonidal sinus disease. Between January and December 2009, 585 patients, treated with surgery in Manisa Merk Efendi State Hospital, were included. Patients were classified according to demographic data, surgical techquie and pathological examination. 104 patients provided all criteria wherein 135 patients have been reached and called for controls. These patients were divided into four groups; modified Karydakis, lay-open, excision with primary closure and finally other flap repairs.? The 104 patients included in the study 98 male, 6 of them were female. The average age of these patients was 24.7. In modified Karydakis group, abscesses and skin necrosis, which are the early postoperative complications, were found in 2 patients. Patient, developing skin necrosis has been re-operation with primary closure method and his follow up, recurrences were found. In lay-open group, the abscess, improving with antibiotics, was developed in one patient. In primary closure group, complications were encountered in two patients in the early postoperative period. The highest rate of recurrence, four patients, was found in this group. Moreover, most complications in early postoperative period were encountered in other flap group. The modification of the original Karydakis flap technique for sinus pilonidal is a type of surgery can be easily and simply believe and applied in repairs of all sizes. ? ?ZET Bu ?al??mada sinüs pilonidal hastal???nda orijinal Karydakis onar?m?n kendimize ait modifikasyonun etkinli?ini ara?t?rmay? ama?lad?k. Ocak 2006 ile Aral?k 2009 tarihleri aras?nda Manisa Merkez Efendi Devlet Hastanesinde pilonidal sinüs hastal??? nedeniyle cerrahi tedavi uygulanm?? 585 hasta ?al??maya dahil edildi. Hastalar demografik verileri, uygulanan cerrahi prosedürler ve cerrahi piyesin patolojik incelemeleri do?rultusunda s?n?fland?r?ld?. Tüm kriterleri sa?layan 135 hastadan 104 tanesine ula??ld? ve kontrole ?a?r?ld?. Bu hastalar uygulanan cerrahi prosedürler do?rultusunda modifiye Karydakis, primer eksizyon a??k b?rakma, eksizyon ve primer kapama ile son olarak di?er flep onar?mlar? olmak üzere 4 gruba ayr?ld?. ?al??maya dahil edilen 104 hastan?n 98 tanesi erkek, 6 tanesi bayan idi. Gruplar aras?nda ayr?m g?stermeden hastalar?n ya? ortalamas? 24,7 olarak saptand?. Modifiye Karydakis uygulanan ilk gruptaki 2 hastada apse ve cilt nekrozu olmak üzere erken ameliyat sonras? komplikasyona rastlanm??t?r. Cilt nekrozu geli?en hasta primer kapama y?ntemi ile yeniden ameliyat edilmi? ve izlemde de nükse rastlanm??t?r. A??k b?rak?lan grupta ise 1 hastada tedaviye yan?t veren apse geli?mi?tir. Primer kapama grubunda ise ameliyat sonras? erken d?nemde iki hastada komplikasyona rastlanm??t?r. Ge? d?nemde 4 hasta ile en yüksek nüks oran?na bu grupta rastlanm??t?r. Di?er flep onar?mlar?nda ise 4 hasta ile en ?ok ameliyat sonras? erken d?nem komplikasyonlar?na rastlanm??t?r. Orijinal Karydakis flep onar?mlar?n modifikasyonu olan tekni?imizin her boyuttaki sinüs pilonidal hastal???na kolay ve basit?e uygulanabilecek bir ameliyat ?ekli olabilece?i kanaatindeyiz.