Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical SurgeryВестник экспериментальной и клинической хирургии2070-478X2409-143XVoronezh State Medical University named after N.N. Burdenko12610.18499/2070-478X-2013-6-3-386-392Original articlesОригинальные статьиUnknownClinical and Anatomical Aspects of Surgical Treatment of Sacrococcygeal Pilonidal Sinus DiseaseХирургическое лечение эпителиального копчикового хода: клинико-анатомические аспектыЖдановА.И.

M.D., professor, Voronezh N.N. Burdenko State Medical Academy, Head of the Department of Hospital Surgery

д.м.н., проф, зав. кафедрой госпитальной хирургии Воронежской государственной медицинской академии им. Н.Н. Бурденко

author@vestnik-surgery.comКривоносовС.В.

Ph.D., Voronezh N.N. Burdenko State Medical Academy, Assistant of the Department of Hospital Surgery

к.м.н., асс. кафедры госпитальной хирургии Воронежской государственной медицинской академии им. Н.Н. Бурденко

author@vestnik-surgery.comБрежневС.Г.

Voronezh N.N. Burdenko State Medical Academy, Postgraduate Student of the Department of Hospital Surgery

аспирант кафе- дры госпитальной хирургии Воронежской государ- ственной медицинской академии им. Н.Н. Бурден- ко

author@vestnik-surgery.comVoronezh State Medical Academy named after N. N. Burdenko, Voronezh, Russian FederationВоронежская государственная медицинская академия имени Н.Н. Бурденко, Воронеж, Российская Федерация24092013633863922704201627042016Copyright ©; 2013, Voronezh N.N. Burdenko State Medical UniversityCopyright ©; 2013, ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России2013Voronezh N.N. Burdenko State Medical UniversityФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава Россииhttps://vestnik-surgery.com/journal/about/editorialPolicieshttps://vestnik-surgery.com/journal/article/view/126

Despite the fact that this disease is the subject of numerous medical journals, monographs, research works, master's and doctoral theses, to date there is no unified approach to the choice of surgical treatment for this disease. High frequency of unsatisfactory results after excision of pilonidal sinus (recurrences - 10% to 19%, wound suppuration - 20-30%) directly depends on the type of surgery. After palliative surgery (incision and drainage of abscess), 73% of patients re-performed surgery, in the treatment of open wounds (excision followed by secondary healing) recurrences occur in 3-8% of the operated. In primary wound healing in 7,5-9,7% of cases are re-occurrence of the disease. Despite the fact that this disease is the subject of numerous medical journals, monographs, research works, master's and doctoral theses, to date there is no unified approach to the choice of surgical treatment for this disease. The analytic review of the national and foreign literature about problem of surgical treatment of sacrococcygeal pilonidal cysts is presented in the article. Here we expound currently available methods of surgical treatment, the main outstanding issue at this point in the treatment of these patients. The basic clinical and anatomical features of the choice of surgery are marked. Shown that the high frequency of the disease and its postoperative complications, as well as long-term temporary disability of patients demonstrate the need of a differential approach to the choice of treatment strategy and surgery. It is also necessary to take into account features of topographic anatomy of the structures of sacrococcygeal region, as well as extent of the inflammatory process

Несмотря на то, что различные методы хирургического лечения больных эпителиальным копчиковым ходом (ЭКХ) описа- ны в многочисленных монографиях, журнальных статьях, кандидатских и докторских диссертациях, единого подхода к выбору способа оперативного лечения при данном заболевании на сегодняшний день нет. Частота неудовлетворительных результатов после иссечения ЭКХ, обуславливающая актуальность проблемы, остается достаточно высокой (рецидивы - от 10 до 19%, нагноение раны - 20-30%) и напрямую зависит от вида хирургического лечения. Так, после паллиативной операции (вскрытия и дренирования гнойника) до 73% пациентов с острым воспалением ЭКХ требуют повторного хирургического лечения, при открытом лечении раны (иссечение ЭКХ с последующим зажив- лением вторичным натяжением) рецидивы наблюдаются у 3-8% оперированных. При ушивании раны наглухо в 7,5-9,7% случаев происходит повторное возникновение заболевания. В статье представлен аналитический обзор отечественной и зарубежной литературы, посвященной проблеме хирургиче- ского лечения пилонидальных кист крестцово-копчиковой области. Приведены виды оперативных пособий, существующих в настоящее время, очерчены основные нерешенные на данный момент проблемы в лечении данного контингента больных. Выделены основные клинико-анатомические особенности выбора хирургического вмешательства. Показано, что высокая частота данного заболевания и его послеоперационных осложнений, а так же длительные сроки временной нетрудоспо- собности пациентов – все это свидетельствует о необходимости дифференцированного подхода к выбору лечебной так- тики и оперативного пособия с учетом особенности топографо-анатомического взаимоотношения структур, составляю- щих ягодично-крестцово-копчиковую область, а так же степени выраженности и распространенности воспалительного процесса

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