مقایسه‌ی نتایج ترمیم اولیه‌ی جراحی سینوس پیلونیدال ساکرال در دو تکنیک tie over و closed suction drainage

مقدمه: بیماری سینوس پیلونیدال یک بیماری دردناک است که بیشتر در ناحیه‌ی اینترگلوتئال ایجاد می‌شود. در برخی مراکز درمانی اغلب از روش excision به همراه ترمیم اولیه جهت درمان این بیماری استفاده می‌شود. اما ممکن است این تکنیک به دلیل ایجاد فضای مرده در محل جراحی عوارضی را به دنبال داشته باشد. در این کارآزمایی بالینی دو تکنیک مختلف عمل جراحی از نظر ایجاد عوارض مورد مطالعه قرار گرفت. روش‌ها: این مطالعه یک کارآزمایی کنترل شده‌ی بالینی بود که در سال‌های 1386 و 1387 در بیمارستان الزهرا (س) اصفهان اجرا شد. بیماران به طور تصادفی به دو گروه 54 نفره‌ی tie over (گروه a) و closed suction drainage (گروه b) تقسیم شدند. بروز عوارض جراحی با استفاده از پرسشنامه‌ای که به همین منظور تهیه شده بود در زمان جراحی و نیز در ویزیت‌های بعدی با یکدیگر مقایسه شدند. در نهایت داده‌ها با استفاده از نرم‌افزارspss نسخه‌ی 13 مورد تحلیل و بررسی قرارگرفت. یافته‌ها: 108 بیمار در این مطالعه شرکت کردند. میانگین سنی آن‌ها 3.6 ± 25.08 سال بود. 94.4 درصد بیماران مرد و 5.6 درصد آن‌ها زن بودند. شیوع عوارض شامل عود بیماری، عفونت زخم جراحی، از هم‌گسیختگی زخم و تجمع سروما در دو گروه تفاوت آماری معنی‌دار نداشت. طول مدت عمل جراحی در گروه a به طور معنی‌داری طولانی‌تر از گروه b بود (0.001 > p). نتیجه‌گیری: بر اساس داده‌های ما برای درمان جراحی بیماری پیلونیدال ساکروکوکسیژآل تفاوتی در نتایج دو تکنیک tie over و closed suction drainage وجود نداشت.

A Comparison between the Outcomes of TieOver and Closed Suction Drainage Techniques in the Management of Sacrococcygeal Pilonidal Sinus Disease

<p><strong>Background</strong>:  Breast cancer, as the most common cancer among women, is the main cause of death in women aged 45 to 55. Therefore, different novel screening methods and technologies to diagnose and treat the disease in its early stages are of high importance for health systems.  The present study aimed to investigate the epidemiological trend, and clinical and treatment indices of breast cancer by collecting available information from SeyedAlShohada Hospital, in Isfahan during 19812006.</p><p><strong>Methods</strong>: All available data at Oncology Center of Isfahan Province, related to 19812006 were encoded and analyzed. Age groups of the patients, along with all cases of cancer recorded by Statistical Center of Iran, were calculated. After age specific rating (ASR), the resulted indices were evaluated. The frequency of clinical indices, such as tumor, metastasis, chemotherapy, and breast conserving surgery, as well as the frequency of age groups among patients, and the ASR pattern were calculated. Correlational tests and mean comparison were used to analyze the data.</p><p><strong>Results</strong>: Among 4652 breast cancer patients, 98.6% were female and 1.35% were male. Total ASR for breast cancer was calculated as 13 in 1996, 14.1 in 2001, and 18.21 in 2006 in the province of Isfahan. The values were then compared with the rate in the country (25.6) during 2006. The age of patients was 48.79 ± 11 years with 34.65% aging 4050, and 26.7% aging less than 40 years. The ASR was estimated as approximately 57 in every 100,000 for age groups of 4150, 5160, and 6170. Categorization of patients based on frequency among different age groups and frequency based on ASR did not result in an identical pattern.  The relative frequency of tumor sizes obtained from the patients were T1 = 7.6%, T2 = 61.2%, T3 = 27.2% and T4 = 3.8%.  In addition, an increasing trend of chemotherapy was observed during the studied period with 71.2% of the patients receiving the treatment. The tendency to perform breast conserving surgery is growing recently and 8.9% of the cases undergone the surgery during 20022006.</p><p><strong>Conclusion</strong>:  The increasing trend of ASR may indicate improved screening methods, staff training development, and modern disease detection equipments. The data proves that compared with most western countries, Iran is in a low risk region. However, changing people's lifestyle and increasing trend in breast cancer incidence would be a matter of caution for the health system.</p>