Journal of pediatric surgery · 2015
Excision versus trichloroacetic acid (TCA) chemocauterization for branchial sinus of the pyriform fossa.
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Hwang Jihee, Kim Seong Chul, Kim Dae Yeon, Namgoong Jung-Man, Nam Soon Yuhl, Roh Jong-Lyel
Аннотация
PURPOSE: We analyzed the outcomes of open surgical excision and endoscopic trichloroacetic acid (TCA) chemocauterization for the treatment of branchial sinus of the pyriform fossa (BSPF).
METHOD: We retrospectively reviewed the records of 27 patients (16 males and 11 females) who were treated for BSPF at the Asan Medical Center between 1996 and 2013.
RESULTS: The median age of the 27 patients was 4.5years (range, 0 to 15years). Before definitive surgery, 19 (70.3%) of the patients had histories of neck infection, and 16 (59.2%) patients had neck abscesses that were drained. The lesions were predominantly located on the left side (26 of 27; 96.2%). Excisions were performed for 14 (48.1%) patients. TCA chemocauterizations were performed for 13 patients. After a median follow-up period of 5.5years, 11 patients developed recurrence. The recurrence rates were not significantly different between the excision and chemocauterization groups (35.7% vs 46.1%, respectively, p=0.704). All of the recurred patients were successfully treated with repeated chemocauterization or reexcision. Analyses of the risk factors for recurrence revealed that a previous infection history tended to increase the rate of recurrence (90.9% vs 56.2%, p=0.090).
CONCLUSION: Our experience suggests that the outcomes of excision and TCA chemocauterization are not significantly different. Additional studies are needed to reach a consensus regarding the best treatment strategy for BSPF.
METHOD: We retrospectively reviewed the records of 27 patients (16 males and 11 females) who were treated for BSPF at the Asan Medical Center between 1996 and 2013.
RESULTS: The median age of the 27 patients was 4.5years (range, 0 to 15years). Before definitive surgery, 19 (70.3%) of the patients had histories of neck infection, and 16 (59.2%) patients had neck abscesses that were drained. The lesions were predominantly located on the left side (26 of 27; 96.2%). Excisions were performed for 14 (48.1%) patients. TCA chemocauterizations were performed for 13 patients. After a median follow-up period of 5.5years, 11 patients developed recurrence. The recurrence rates were not significantly different between the excision and chemocauterization groups (35.7% vs 46.1%, respectively, p=0.704). All of the recurred patients were successfully treated with repeated chemocauterization or reexcision. Analyses of the risk factors for recurrence revealed that a previous infection history tended to increase the rate of recurrence (90.9% vs 56.2%, p=0.090).
CONCLUSION: Our experience suggests that the outcomes of excision and TCA chemocauterization are not significantly different. Additional studies are needed to reach a consensus regarding the best treatment strategy for BSPF.