comparative study between open excision and modified bascom's technique in sacro- coccygeal pilonidal sinus

Pilonidal sinus is a common disabling disease of young adults involving the sacro- coccygeal area, in the natal cleft, consisting of one or more, usually non-infected, midline openings, which communicate with a fibrous track lined by granulation tissue and containing hair lying loosely within the lumen. Many of the standard surgical procedures are associated with a significant risk both of delayed healing and of recurrent disease. The study aimed to comparing the results of excision and packing method with those of lateral approach [Modified Bascom's procedure] in the treatment of sacro - coccygeal pilonidal sinus in regard to the hospital stay, time required for complete healing, time required to return to daily job or activity, early complications [infection, wound hematoma or seroma] and late complications [scar and recurrence]. Eighty patients were operated on electively for pilonidal sinus, [62] male, [18] female who underwent elective operations of sacro-coccygeal pilonidal sinus at AL-Karama Teaching Hospital between June 2009 - June 2014. Two surgical procedures were carried out, excision and packing [40 patients, group A] and modified Bascom's procedure [lateral approach] [40 patients, group B]" Five patients omitted from further follow 'up, two cases related to excision and packing and three of modified Bascom's procedure. It has been found that the third decade of life is the most frequent age group at which patient presenting symptoms was discharge [61.2%] and pain [26.2%] although both present in combination in most cases' 75% and 52%] of patients had discharge and pain respectively during the presenting period . The duration of the disease was from one month to two years. It has been concluded that there was no significant difference in the occurrence of the early complication [infection, seroma / hematoma] 25% for group A and 37.5% group B, and recurrence rate l0.5 % for group A and 16.2% for group B, thus patients in group B provided a significantly quicker healing time [mean 49 days for group A and 28 days for group B]. Shorter time - work [mean 47.8 days for group A and 28 days for group B] with better patient convenience [more pain free period], needs only simple oral analgesia, no patient needed hospital admission for pain control no dressing required and less risk of wound break down. The study had shown that modified Bascom's procedure for pilonidal sinus is safe and feasible as day-care surgery and is associated with potential cost saving

comparative study of excision with laying open and modified bascom's technique in sacro-coccygeal pilonidal sinus

The study aimed to compare the results of excision and laying open to achieve primary healing method to those of lateral approach [modified Bascom's procedure] in the treatment of sacro-coccygeal pilonidal sinus in regard to the hospital stay, time required for complete healing, time required to return to daily job or activity, early complications [bleeding, infection, wound hematoma or seroma] and late complications [scar and recurrence]. Methods: Eighty patients underwent elective surgery for there pilonidal sinus, 62 males, 18 females at Al-Karama Teaching Hospital [Baghdad, Iraq], between June 2009 and June 2014. Two surgical procedures were carried out, excision and laying open [40 patients, group A] and modified Bascom's procedure [lateral approach] [40 patients, group B]. Five patients omitted from further follow up, two cases related to excision and packing and three of modified Bascom's procedure. Results: It has been found that the third decade of life is the most frequent age group at which patients presenting. It has been concluded that there was no significant difference in the occurrence of the early complications [bleeding, infection, seroma/hematoma], 25% for group A and 37.5% group B, and recurrence rate 10.5% for group A and 16.2% for group B, but patients in group B provided a significantly quicker healing time [mean 49 days for group A and 28 days for group B]. Shorter time-work [mean 47.8 days for group A and 28 days for group B] with better patient convenience [more pain free period], needs only simple oral analgesia, no patient needed hospital admission for pain control, no dressing required and less risk of wound breakdown. Conclusions: The study showed that modified Bascom's procedure for pilonidal sinus is an attractive, safe, easily performed operation with minimal morbidity and feasible as day-care surgery

Idiopathic benign retroperitoneal cyst: uncommon retroperitoneal mass

Retroperitoneal cysts are uncommon, with an estimated incidence of 1/5750 to 1/250.000. We found a case of a 54th years old female in Al-Karama Teaching Hospital with sensation of mild left lower abdominal pain colicky in nature with mild backache, ten days duration. No dysuria, normal bowel motion. On physical examination we palpated a fixed mass in the left lateral side of abdomen, ultrasound, and CT-scan were done, first we thought it is probably a mesenteric cyst but this cyst was fixed not mobile in nature. During the operation we found a retroperitoneal cyst at the lateral side of sigmoid colon and extend posterior to the descending colon. The cyst arising within the retroperitoneum outside the major organs. CT scan, and MRI might help in investigation of a retroperitoneal cyst, but surgery is the keystone in confirming the diagnosis, and surgery remains the best treatment option

[Dermoid cyst of the spermatic cord: a rare case of benign inguinal lump]

Dermoid cyst of the spermatic cord is an extremely rare pathological state seen at the general surgery and the urological clinic. We present a case of a nineteen year old male who presented with a painless left groin lump, irreducible, and no cough impulse from childhood, both testes presented in the scrotum and were normal in size and shape. From the history, physical examination, ultrasound examination, we thought it was a lipoma, a hydrocele of the spermatic cord, or irreducible inguinal hernia. During the operation, suspicion of a dermoid cyst of spermatic cord occurred from a sebum and hair which discharged from the cyst during dissection of the cyst from spermatic cord. The final histopathological analysis established the diagnosis of dermoid cyst of spermatic cord