| Objective:To explore the risk factors of sacrococcygeal pilonidal sinus,and then to prevent the occurrence of the disease;To analyze the curative effect of three surgical methods in the treatment of sacrococcygeal pilonidal sinus,and to find a better surgical treatment plan.Methods:Study on the risk factors of sacrococcygeal pilonidal sinus:According to the inclusion and exclusion criteria,all patients with sacrococcygeal pilonidal sinus admitted to Dalian NO.3 People’s Hospital from December 2014 to October 2022 were retrospectively analyzed as the case group,and patients with mixed hemorrhoids treated during the same period were used as the control group.Chi-square test,t test,and rank sum test statistical methods were used to analyze the correlation between the two groups in terms of gender,age,BMI,personal hygiene(bath times per week),sacrococcygeal body hair,sedentary habits,family history,skin color,oily skin and habit of wearing tights(jeans).At the same time,binary logistic regression analysis was used to explore the independent risk factors and degree of sacrococcygeal pilonidal sinus.Evaluation of the curative effect of different surgical methods in the treatment of sacrococcygeal pilonidal sinus:According to the inclusion and exclusion criteria,the clinical data of patients who underwent sacrococcygeal pilonidal sinus surgery in Dalian NO.3 People’s Hospital from December 2014 to February 2022 were collected.According to different surgical methods,they were divided into 3 groups–incision and drainage of sacrococcygeal pilonidal sinus group,simple resection of sacrococcygeal pilonidal sinus group,and resection of sacrococcygeal pilonidal sinus+in situ flap free plasty group.Firstly,the comparability of clinical data among the three groups of patients was evaluated by chi-square test and analysis of variance,and then the operation time,hospitalization time,pain score on the first day after the operation,the incidence of postoperative complications,and 1-year recurrence rate after operation were compared by rank sum test,t test,and chi-square test statistical methods.Results:The two factors of family history(χ~2=1.59,P=0.207)and skin color(χ~2=3.01,P=0.222)of patients with sacrococcygeal pilonidal sinus had no statistical significance in sacrococcygeal pilonidal sinus(P>0.05);There were statistically significant(P<0.05)between the patient’s gender(χ~2=5.13,P=0.023),age(Z=-2.25,P=0.024),BMI(t=4.86,P<0.001),number of baths per week(χ~2=10.36,P=0.001),sacrococcygeal body hair(χ~2=17.67,P<0.001),sedentary(χ~2=3.90,P=0.048),oily skin(χ~2=7.83,P=0.005),and habit of wearing tight pants(χ~2=6.63,P=0.010)and the sacrococcygeal pilonidal sinus.Young age(OR=0.86,95%CI0.80-0.93,P<0.001),high BMI(OR=1.27,95%CI1.08-1.50,P=0.005),poor personal hygiene(OR=0.05,95%CI0.01-0.25,P<0.001),and think body hair(OR=4.78,95%CI1.28-17.90,P=0.020)were the independent risk factors for the sacrococcygeal pilonidal sinus.The average operation time of the incision and drainage of sacrococcygeal pilonidal sinus group was 11.00±4.60 minutes,which was significantly shorter than the other two groups.The operation time of the simple resection of sacrococcygeal pilonidal sinus group was shorter than that of the resection+in situ flap free plasty group(Z=-2.88,P=0.004).There were statistical differences in the overall distribution of hospitalization time among the three groups(H=12.19,P=0.002),and the incision and drainage group had the shortest hospitalization time.However,there was no significant difference in hospitalization time between the resection of sacrococcygeal pilonidal sinus+in situ flap free plasty group and the simple resection group(adj.P>0.05).The VAS pain score on the first day after the operation in the resection of sacrococcygeal pilonidal sinus+in situ flap free plasty group was lower than that in the simple resection group(t=2.08,P=0.045),but there was no statistical difference in the incidence of postoperative complications between the two groups(χ~2=1.79,P=0.181).There were statistical differences in the recurrence rate of the three groups at 1 year after operation(χ~2=5.98,P=0.023),and the recurrence rate was the highest in the incision and drainage of sacrococcygeal pilonidal sinus group.Conclusion:Young males are prone to the occurrence of sacrococcygeal pilonidal sinus,and the ratio of male to female is about 3:1.Gender,age,BMI,personal hygiene,body hair,sedentary habits,oily skin,and wearing tight pants are correlated with the incidence of sacrococcygeal pilonidal sinus.Young age,high BMI,poor personal hygiene,and thick body hair are independent risk factors for the sacrococcygeal pilonidal sinus.The risk of disease can be reduced through targeted prevention,such as weight loss,frequent bathing,avoiding sedentary,regular shaving,or hair removal of the sacrococcygeal region.Incision and drainage of the sacrococcygeal pilonidal sinus has the advantages of simple operation,short operation time,and quick postoperative recovery.However,the recurrence rate is relatively high.It is recommended that this operation be used for the symptomatic treatment of the pilonidal sinus in the acute stage,and further radical surgery should be performed after the condition is stable.Compared with simple resection of sacrococcygeal pilonidal sinus and resection of sacrococcygeal pilonidal sinus+in situ flap free plasty,although the operation time of the former is shorter,the postoperative pain perception of patients is significantly higher than that of the latter.Although there is no statistical difference in postoperative complication rate and recurrence rate,the general trend is that the former is higher than the latter.Therefore,resection of sacrococcygeal pilonidal sinus+in situ flap free plasty is more worthy of being widely used in clinical practice. |
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