Thirteen shortcuts in office surgery.
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Abdomen, Acute↗
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Results for “PILONIDAL CYST”
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[Cutaneous tumors and nodules in the neonatal period].
A review of neonatal cutaneous tumors and nodules is presented, based on a 10-year experience. Pitfalls in diagnosis are especially emphasized. A biopsy should be performed in most instances when there is a clinical doubt.
Dermoid Cyst↗
A method for primary reconstruction following radical excision of sacrococcygeal pilonidal disease.
A great variety of procedures have been proposed for the cure of Sacrococcygeal pilonidal disease. Initial enthusiasm has usually given way to disappointment when it is realized that the treatment is painful, the hospitalization is prolonged, the aftercare is tedious or the original condition appears to have recurred. A technique is described which permits the total extirpation of cyst and sinus tracts while allowing for a tensionless wound closure by advancement of a buttock flap. Hospitalization is brief and the postoperative course is comfortable. Fifty such operations have been performed since November 1968. In the first group of thirty patients operated upon between three and ten years ago, a single bonafide failure occurred. An additional twenty patients have been successfully treated for an overall failure rate of 2%.
Adolescent↗
[Interdigital pilonidal sinus in barbers].
Three cases of barber's hair sinus of the hand are presented. The lesion is produced by the penetration of extraneous short hairs into the interdigital spaces of the hand. The hairs produce an inflammatory reaction and foreign body granuloma. The clinical picture is usually benign but can be complicated by repeated infection which may require surgery. The structure of the lesions varies from epithelial-lined tract, cyst with surrounding foreign body reaction, to fibrotic cicatricial tissue. The exact reasons for the lesion are not known, but several theories are offered. It is, however, clear that since the 1970's Italian barbers have changed their methods of cutting hair, using their hands more than the customary instruments, i.e., combs, brushes, etc. The authors discuss the occupational problems due to the complications of disabling lesions.
Adult↗
Outpatient operations. I. The surgeon's view.
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Adolescent↗
Total subcutaneous fistulectomy combined with Karydakis flap for sacrococcygeal pilonidal disease with secondary perianal opening.
OBJECTIVE: Flap techniques have been performed with success in the treatment of pilonidal disease. However, some complex cases such as perianal pilonidal disease need special attention. We describe a modification of a well-known flap technique for secondary perianal pilonidal disease and its early results. PATIENTS AND METHOD: Total subcutaneous fistulotomy combined with Karydakis flap was performed on 14 patients. An elliptical incision, described by Karydakis, was made while not including the perianal opening. Both sides of the elliptical incision were deepened down to the gluteal muscle and postsacral fascia. At the level of subcutaneous tissue, attention was directed to the secondary perianal opening. A fine probe was inserted through the perianal skin pit, and the connection site between the fistula and the cyst was observed. A small circular skin incision was made around the probe and the fistula tract was totally excised using electrocautery together with the main cyst. The flap was prepared as described by Karydakis. Before suturing the flap to the other side, perianal subcutaneous tissue was sutured with a fine absorbable material, then, the flap was sutured with 4/0 polypropylene. RESULTS: One patient developed seroma. Neither early failure in wound healing nor recurrence was observed at a mean of 16.2 months (range 4-36 months) follow-up. CONCLUSION: Total subcutaneous fistulectomy plus Karydakis flap as a single-stage procedure is an effective surgical modality for sacroccocygeal pilonidal disease with secondary perianal opening.
Anal Canal↗
Roentgenological changes in spinal malformations and spinal tumours in children.
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Adolescent↗
[Eruptive vellus hair cysts].
Eruptive vellus hair cysts are rare epidermal cysts with vellus hairs, which appear in children or young adults. A 21-year-old patient is reported who developed asymptomatic comedo-like papules on his face, neck and chest. Histopathologically, epidermoid cysts with a fine stratum granulosum, laminated keratinous material and numerous vellus hairs were found in the mid-dermis. Evaluation of immediate family members revealed that the patient's father was similarly affected. Eruptive vellus hair cysts and steatocystoma multiplex are clinically similar, but have distinctive histopathological features and should be regarded as distinct entities.
Adult↗
[Removal and immediate suture of sacrococcygeal cysts].
A series of 25 patients suffering from sacrococcygeal cyst-fistula treated by surgical removal and immediate, complete suture of the wound is reported. Functional recovery was complete and there no recurrences. Average postoperative hospitalization was also much shorter than that obtaining when other surgical techniques are used.
Adolescent↗
[Surgical treatment of the non suppurated sacrococcygeal cyst. Technical improvements].
Some justified technical improvements have been made to the method of treatment for non-infected and sacro-coccygienally located "pilo-nidal". The absence of tension due to the use of a rotational autoplasty and the drying of the residual cavity by an efficient aspirative drainage are the means essentially employed.
Adipose Tissue↗
[Sacrococcygeal cysts. Is Lord Millar's procedure an alternative to exeresis?].
The benignancy of sacrococcygeal cysts stands in contrast to their morbidity and rate of recurrence. Due to the differences in the results found in the literature and to the lack of recommendations as to the optimal surgical procedure, the authors have reviewed a series of 69 patients with a chronic inflammatory state. The procedure was either exeresis up to the sacrum (37 patients) or Lord Millar's procedure (32 patients). The latter consisted in a limited exeresis of the portals and in the extraction of the hairs with a brush, followed in principle by a weekly depilatory treatment until the wound was closed. The results in the 2 groups have been compared. Sixty-six patients (87%) were controlled after an average of 3.7 years. The shorter stay in hospital of the patients operated with Lord Millar's procedure (4.9 vs. 7.6 days) and the shorter period of inability to work (14 vs. 26 days) demonstrate the socioeconomical advantage of this procedure. Recurrence occurred in 5 of the 31 patients controlled after exeresis (16%) and in 7 of the 29 patients controlled after a Lord Millar's operation (24%), including one in the subgroup of 16 patients who submitted themselves to a regular postoperative epilatory treatment (6%) and 6 in the group of 13 who were not followed up in our clinic (46%). Thus Lord Millar's procedure represents an alternative to exeresis, provided the patient is motivated enough to submit himself to regular postoperative controls.
Adolescent↗