Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector101310.17816/psaic1013Original Study ArticlesОригинальные исследованияResearch ArticleMinimally invasive treatment of pilonidal cysts in children: the Gips procedureМинимально инвазивное лечение детей с пилонидальными кистами: способ GIPShttps://orcid.org/0000-0001-5821-70597825-8561StepanovaNataliya M.СтепановаНаталия Маратовна
Russian Federation

Cand. Sci. (Med.), Associate Professor of the Department of Pediatric Surgery

канд. мед. наук, доцент кафедры детской хирургии

dm.stepanova@mail.ruhttps://orcid.org/0000-0002-9309-66915633-5491NovozhilovVladimir A.НовожиловВладимир Александрович
Russian Federation

MD, Dr. Sci. (Med.), Professor, Head of the Department of Pediatric Surgery, Chief Physician

д-р мед. наук, профессор, заведующий кафедрой детской хирургии; главный врач

novozilov@mail.ruhttps://orcid.org/0000-0003-4763-83386262-3207MochalovMikhail N.МочаловМихаил Николаевич
Russian Federation

Pediatric Surgeon

врач-хирург детский

mnm-m.d@mail.ruhttps://orcid.org/0000-0002-7167-25206620-6758ZvonkovDenis A.ЗвонковДенис Андреевич
Russian Federation

Pediatric Surgeon

врач-хирург детский

denis.zvonkov@mail.ruhttps://orcid.org/0000-0001-6709-31235268-1950VoropaevaAnastasia V.ВоропаеваАнастасия Витальевна
Russian Federation

Clinical Resident

клинический ординатор кафедры детской хирургии

voropaeva300996@mail.ruhttps://orcid.org/0000-0002-1083-09519949-7707PetrovEvgeniy M.ПетровЕвгений Михайлович
Russian Federation

Pediatric Surgeon, Head of the Department of pediatric surgery

врач-хирург детский, заведующий отделением детской хирургии

emp1976@rambler.ruhttps://orcid.org/0000-0003-2039-27614915-5348MorozSergey V.МорозСергей Владимирович
Russian Federation

Pediatric Surgeon

врач-хирург детский

morozsv@mail.ruhttps://orcid.org/0000-0001-7018-30078185-7522KhaltanovaDora Yu.ХалтановаДора Юрьевна
Russian Federation

Pediatric Surgeon

врач-хирург детский

khaltanovad@mail.ruhttps://orcid.org/0000-0001-6368-64745525-8518NamkhanovVyacheslav V.НамхановВячеслав Валентинович
Russian Federation

Associate Professor of the Department of Faculty Surgery

доцент кафедры факультетской хирургии

namhanov@yandex.ruIrkutsk State Medical UniversityИркутский государственный медицинский университетIvano-Matreninskaya Children’s Clinical HospitalГородская Ивано-Матренинская детская клиническая больницаBuryat State UniversityБурятский государственный университет180320221204202212161682110202107022022Copyright ©; 2022, Stepanova N.M., Novozhilov V.A., Mochalov M.N., Zvonkov D.A., Voropaeva A.V., Petrov E.M., Moroz S.V., Khaltanova D.Y., Namkhanov V.V.Copyright ©; 2022, Степанова Н.М., Новожилов В.А., Мочалов М.Н., Звонков Д.А., Воропаева А.В., Петров Е.М., Мороз С.В., Халтанова Д.Ю., Намханов В.В.2022Stepanova N.M., Novozhilov V.A., Mochalov M.N., Zvonkov D.A., Voropaeva A.V., Petrov E.M., Moroz S.V., Khaltanova D.Y., Namkhanov V.V.Степанова Н.М., Новожилов В.А., Мочалов М.Н., Звонков Д.А., Воропаева А.В., Петров Е.М., Мороз С.В., Халтанова Д.Ю., Намханов В.В.https://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/1013

BACKGROUND: Pilonidal disease (pilonidal cyst, epithelial coccygeal passage) is a chronic inflammatory disease of the sacrococcygeal region, common among young people, including adolescents, to a certain extent worsens the quality of life. Until now, the etiopathogenesis and surgical treatment methods of the disease have been the subject of wide discussion.

AIM: The aim of the study was to evaluate the effectiveness of Gips operations in children with pilonidal disease.

MATERIALS AND METHODS: A comparative analysis of 41 patients with pilonidal disease was conducted in the surgical department of the City Ivano-Matryoninsk Children's Clinical Hospital in Irkutsk from January 2020 to August 2021. Planned surgical treatment was performed in 22 patients with primary or recurrent pilonidal cysts, including 15 children using the M. Gips procedure. The comparison group consisted of patients who underwent wide excision of a complex of soft tissues bearing a pilonidal cyst, primary and secondary fistulous passages, followed by wound restoration with a storey suture.

RESULTS: The patients comprised 72.7% boys and 27.3% girls with an average age of 15.6 ± 1.5 years and average disease duration of 5.1 ± 2.2 months. The average operation time was 12 ± 4.2 minutes. The motor regime was resumed on the first day after the operation. Patient pain was relieved by administering non-steroidal anti-inflammatory drugs for the first two postoperative days. There were no early postoperative complications. The average hospital stay was 3.8 ± 1.9 days. Complete healing by secondary intention was achieved after an average of 3.9 ± 1.8 weeks. The average follow-up was 7 ± 3.8 months, and 6.7% had early relapses.

CONCLUSIONS: Minimally invasive sinusectomy according to the Gips procedure for treating pilonidal disease in adolescents is safe and effective, has a low recurrence rate, allows an early return to daily activities, and provides a good cosmetic result. However, the small number of observations requires further research.

Актуальность. Пилонидальная болезнь (пилонидальная киста, эпителиальный копчиковый ход) — хроническое воспалительное заболевание крестцово-копчиковой области, распространенное среди лиц молодого возраста. До настоящего времени этиопатогенез и способы хирургического лечения заболевания являются предметом широкой дискуссии.

Цель исследования — оценить эффективность применения операций по Gips у детей с пилонидальной болезнью.

Материалы и методы. Проведен сравнительный анализ лечения 41 пациента с пилонидальной болезнью в Городской Ивано-Матренинской детской клинической больнице Иркутска за период с января 2020 г. по август 2021 г. Плановое оперативное лечение было выполнено 22 пациентам с первичной или рецидивирующей пилонидальной кистой, из них с использованием процедуры М. Gips — 15 детям. Группу сравнения составили пациенты, которым выполняли широкое иссечение комплекса мягких тканей, несущих пилонидальную кисту, первичные и вторичные свищевые ходы, с последующим восстановлением раны этажным швом.

Результаты. Гендерный состав: 73,3 % юношей и 26,7 % девушек. Средний возраст —15,6 ± 1,5 года. Средний срок заболевания — 5,1 ± 2,2 мес. Среднее время операции — 12 ± 4,2 мин. Возобновление двигательного режима происходило в первые сутки после операции. Обезболивание путем приема нестероидных противовоспалительных средств применяли в первые 2 дня послеоперационного периода. Ранних послеоперационных осложнений не отмечено. Среднее время пребывания в больнице — 3,8 ± 1,9 сут. Полное заживление вторичным натяжением — в среднем через 3,9 ± 1,8 нед. Катамнез в среднем составил 7 ± 3,8 мес.: ранние рецидивы у 6,7 %.

Вывод. Минимально инвазивная синусэктомия по способу Gips для лечения пилонидальной болезни у подростков безопасна и эффективна, имеет низкую частоту рецидивов, позволяет в ранние сроки вернуться к повседневной деятельности и обеспечивает хороший косметический результат. Однако малое число наблюдений требует проведения дальнейшего исследования.

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