当前位置： SCI文献检索 > Techniques in Coloproctology期刊下所有文献 > Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus.

Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus.

Abstract：

BACKGROUND:There are different open healing and primary closure approaches for chronic pilonidal sinus (CPD) that differ in principles and extension. AIMS:To compare the results of different closure surgical techniques, we performed a meta-analysis of randomized controlled trials (RCT) comparing: (1) open wide excision versus open limited excision (sinusectomy) or unroofing (sinotomy); (2) midline closure (conventional and tension-free) versus off-midline; (3) advancing versus rotation flaps; and (4) sinusectomy/sinotomy versus primary closure. METHODS:Data extraction and risk of bias assessment were conducted independently by the authors using the Cochrane Collaboration's tool. Data were pooled using fixed and random-effects models. Primary outcomes were rate of healing, recurrence, wound infection and dehiscence. Twenty-five trials (2,949 patients) were included. RESULTS:Four trials compared limited versus radical open healing. Although recurrence rate did not differ, all other outcomes favored the limited approach. Ten studies compared midline versus off-midline primary closure; wound infection and dehiscence were significantly higher after midline closure. Six RCT compared Karydakis/Bascom versus Limberg. No difference was found in recurrence or wound complications rate. Six RCT compared sinusectomy/sinotomy versus primary closure. Recurrence rate was significantly lower after sinusectomy/sinotomy; no significant differences were found in other outcomes. CONCLUSION:Our meta-analysis suggest that some of the questions of which is the best surgical technique for CPD have now been answered: open radical excision and primary midline closure should be abandoned. Sinusotomy/sinectomy or en bloc resection with off midline primary closure are the preferred approaches.

journal_name

Tech Coloproctol

journal_title

Techniques in coloproctology

authors

Enriquez-Navascues JM,Emparanza JI,Alkorta M,Placer C

doi

10.1007/s10151-014-1149-5

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

863-72

issue

eissn

1123-6337

issn

1128-045X

journal_volume

pub_type

杂志文章,meta分析

在线工具

Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus.