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Results of surgical treatment of pilonidal sinus in 50 patients operated using Bascom II procedure – prospective study

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Dutkiewicz P., Ciesielski P., Kołodziejczak M.
Polish Journal of Surgery
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2019
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vol. 91(5)
21-26
EN
Introduction: Treatment of the pilonidal sinus, due to various surgical methods, remains the current topic of discussion during surgeon meetings worldwide. The newest methods of treatment consist in the excision and simultaneous closure of the wound with cleft lift procedures. One of such methods is Bascom II procedure which has been widely used in the world but is less popular in Poland. Aim of the study: To evaluate the results of treatment of pilonidal cysts using Bascom II procedure performed by one operator. Material and method: 50 patients (40 men, 10 women), Avg. 30.6 years of age. All patients treated with Bascom II procedure in one surgical ward by one operator (resident during specialisation training) with the use of uniform surgical care for all operational protocols. The following were assessed: BMI, average hospitalisation time, pain, post-operative complications, wound healing time, patient’s quality of life, and the recurrences rate after surgery. The follow-up period ranged from 12 to 52 months. Results: Average BMI 27.13 kg / m2. Avg. time of hospitalisation 2.95 days. Post-operative pain in the first 24 hours was on average 4.55 points. (+/- 2.24 points); on the 10th day on average 2.04 points (+/- 1.58 points); in the 30th day on average 0.76 points (+/- 1.1 points). Pain after healing 0.14 points (+/- 0.40 points). Post-oerative complications occurred in 28.57% of patients [partial wound dehiscence (16.32%), serum leak (10.2%), hematoma (6.12%), total wound dehiscence (0%), wound infection (0%)]. The average time of full healing was 2.94 weeks. Recurrence occurred in one patient (2.04%). Conclusions: Bascom II procedure is characterised by a low recurrence rate and short wound healing time. It is a a safe, effective and patient-accepted method of treatment. Statistically, it significantly improves the patient’s quality of life one year after surgery in terms of both physical and mental health.
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Wyniki operacyjnego leczenia torbieli pilonidalnej u 50 pacjentów operowanych metodą Bascom 2 – badanie prospektywne

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Dutkiewicz P., Ciesielski P., Kołodziejczak M.
Polish Journal of Surgery
|
2019
|
vol. 91(5)
21-26
PL
Wstęp: Z uwagi na brak jednoznaczności w wyborze metody operacji, leczenie torbieli pilonidalnej pozostaje aktualnym tematem dyskusji w trakcie spotkań chirurgów z różnych krajów. Najnowsze metody leczenia polegają na wycięciu i jednoczasowym zamknięciu rany z przesunięciem szpary pośladkowej. Jedną z nich jest szeroko stosowana na świecie i jednocześnie mało popularna w Polsce technika operacyjna sposobem Bascom 2. Cel pracy: Ocena wyników operacyjnego leczenia torbieli pilonidalnych metodą Bascom 2 przeprowadzonych przez jednego operatora. Materiał i metoda: 50 pacjentów (40 mężczyzn, 10 kobiet), śr. wieku: 30,6 lat, wszyscy zoperowani metodą Bascom 2 w jednym oddziale chirurgicznym przez jednego operatora (rezydent w trakcie szkolenia specjalizacyjnego) z zastosowaniem jednolitego protokołu operacyjnego opieki okołooperacyjnej. Oceniano: BMI, średni czas hospitalizacji, ból, powikłania pooperacyjne, czas gojenia rany, jakość życia pacjenta, odsetek nawrotów po operacji. Okres obserwacji wyniósł od 12 do 52 miesięcy. Wyniki: Średnie BMI – 27,13 kg/m2. Średni czas hospitalizacji – 2,95 dnia. Ból pooperacyjny w 1. dobie wyniósł średnio 4,55 pkt. (+/- 2,24 pkt.), w 10. dobie śr. 2,04 pkt. (+/- 1,58 pkt.), a w 30. dobie śr. 0,76 pkt. (+/- 1,1 pkt.). Ból po wygojeniu to śr. 0,14 pkt. (+/- 0,40 pkt.). Powikłania pooperacyjne wystąpiły u 28,57% pacjentów [częściowe rozejście rany (16,32%), wyciek treści surowiczej (10,2%), krwiak (6,12%), całkowite rozejście rany (0%), zakażenie rany (0%)]. Średni czas pełnego wygojenia to 2,94 tygpdnie. Nawrót choroby wystąpił u jednego badanego (2,04%). Wnioski: Operacja metodą Bascom 2 charakteryzuje się niskim odsetkiem nawrotów oraz krótkim czasem gojenia rany. Jest bezpieczna, skuteczna i akceptowana przez pacjentów. Statystycznie znamiennie poprawia jakość życia chorego rok po operacji zarówno pod względem oceny zdrowia fizycznego, jak i psychicznego.
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Usefulness of electrosurgical techniques in thyroid gland surgery

76%
Kowalski B., Bierca J., Zmora J., Kołodziejczak M., Kosim A., Frączek M.
Polish Journal of Surgery
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2012
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vol. 84(5)
225-229
EN
Wide propagation of new generation of electrosurgical devices such as bipolar vessel sealing systems (eg. Thermostapler® by EMED) enabled seamless closing of blood vessels with a diameter up to 7 mm while maintaining the necessary safety margin, as well as reducing the duration of the operation. We decided to verify these reports in our material. Aim of the study was comparison of thyroid surgery performed with the electrocautery tool – Thermostapler® by EMED with surgery using classic hemostasis technique to evaluate the operative time and complications in the form of bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. Material and methods. We retrospectively analyzed 256 patients operated in the Department of General and Proctological Surgery Solec Hospital in Warsaw due to inert thyroid goitre. All patients underwent total thyroidectomy. Patients were divided into two groups. The first group consisted of 126 patients operated in 2000, using classic techniques of hemostasis. While the second group consisted of 130 patients operated in 2007-2008 with Thermostapler®. We compared duration of surgery and the incidence of postoperative complications. Results. The operative time was significantly shorter (average 18 minutes) in the second group of patients. We also recorded a statistically significant decrease in the incidence of complications in the group operated with Thermostapler. conclusions. Use of bipolar vessel sealing system in a decisive manner shortens the duration of operation. Use of bipolar vessel sealing system also enables a radical reduction in the incidence of complications rate such as bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. In the future, similar studies should be performed to assess the real costs resulting from the use Thermostapler®
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