The Cleft Lift procedure for pilonidal disease renamed as a rotation and advancement flap procedure (RAF): Insights and technical tips for a successful outcome

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery Pub Date : 2022-12-01 DOI:10.1016/j.scrs.2022.100913

Jeffrey A. Sternberg MD

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引用次数: 2

Abstract

Introduction

The Cleft Lift procedure originally named by Bascom is a derivative of the Karydakis flap procedure for pilonidal sinus disease. The terminology and variations of the name have long confused surgeons and have limited its wide adoption.

Technique

This technical paper deconstructs the confusing terminology, suggests simple steps for success, and proposes a more descriptive name for the asymmetric flap procedure which has the lowest reported recurrences for all surgical options for pilonidal disease.

Results

The author has successfully performed the Cleft Lift procedure for pilonidal disease since 2000. In the last consecutive 757 patients treated over 12 years, only 6 patients have required a second operation. This cohort included 287 patients referred with recurrent disease or open wounds from prior pilonidal surgery. A new naming scheme is proposed that more accurately describes the operation. The proposed name is the pilonidal RAF procedure for rotation (around the anus) and advancement (across the natal cleft midline) flap .

Conclusions

The pilonidal RAF procedure is highly successful in treating pilonidal sinus disease with a very low need for additional surgery even in complex recurrent disease.

查看原文本刊更多论文

针对毛鞘疾病的裂口提升手术更名为旋转和推进皮瓣手术(RAF):成功结果的见解和技术提示

最初由Bascom命名的Cleft Lift手术是用于治疗毛髓窦疾病的Karydakis皮瓣手术的衍生产品。长期以来，这个名字的术语和变体一直困扰着外科医生，并限制了它的广泛采用。这篇技术论文解构了令人困惑的术语，提出了成功的简单步骤，并为非对称皮瓣手术提出了一个更具描述性的名称，该手术在所有治疗毛鞘疾病的手术选择中报道的复发率最低。结果自2000年以来，作者成功实施了腭裂提升术治疗毛鞘疾病。在过去12年连续治疗的757例患者中，只有6例患者需要第二次手术。该队列包括287例既往脊髓手术后复发性疾病或开放性伤口的患者。提出了一种新的命名方案，更准确地描述了该操作。建议将其命名为毛毛RAF手术，用于旋转(肛门周围)和推进(越过出生裂隙中线)皮瓣。结论毛毛RAF手术在治疗毛毛窦疾病方面非常成功，即使是复杂的复发性疾病，也不需要额外的手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Colon and Rectal Surgery SURGERY-

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： Seminars in Colon and Rectal Surgery offers a comprehensive and coordinated review of a single, timely topic related to the diagnosis and treatment of proctologic diseases. Each issue is an organized compendium of practical information that serves as a lasting reference for colorectal surgeons, general surgeons, surgeons in training and their colleagues in medicine with an interest in colorectal disorders.