Could Early Postoperative Complications be Considered as Risk Factor for Recurrence after Pilonidal Sinus Surgery?

Demiryas, Süleyman; Dönmez, Turgut

doi:10.21614/chirurgia.114.4.475

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…In most studies comparing treatment methods based on state of smoking, no statistically significant difference was found (13)(14)(15). In our study, 18 (9.8%) of 184 patients were operated as relapse cases.…”

Section: Discussioncontrasting

confidence: 59%

Comparison of Surgical Methods in Sacrococcygeal Pilonidal Sinus Treatment

Çantay

Daşdemir²

2021

Journal of Basic and Clinical Health Sciences

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Purpose: Although many conservative and surgical methods have been described in the treatment of sacrococcygeal pilonidal sinus, which is a common disease of the sacrococcygeal region, affecting especially young men, recurrence rates are still high and the search for ideal treatment continues. The aim of the study is to compare the primary closure, Limberg and Karydakis flap methods for pilonidal sinus surgery in terms of wound healing, complications and recurrence and to present the results accordingly. Methods:The data of 184 patients who were operated between 2018 and 2020 were retrospectively evaluated. Patient data on age, gender, comorbidity, Body Mass Index (BMI), smoking, recurrence, history of preoperative abscess drainage, surgical methods, length of hospital stay, postoperative drain, recurrence and complications were evaluated. Results:No statistically significant difference was found between the treatment methods in terms of age, gender, Body Mass Index, and smoking (p>0.005). A statistically significant difference was found between the treatment methods in terms of reoperation for recurrence and preoperative abscess drainage (p = 0.012) (p = 0.044). However, a significant difference was found between the treatment methods in terms of length of hospital stay, presence of drainage, recurrence and complications (p <0.005). Conclusion:Although primary suturation has a short hospital stay, the rate of recurrence and complications is higher than the Limberg and Karydakis flap methods. In this context, it can be maintained that the Limberg and Karydakis flap methods are safer methods than the primary closure method.

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Section: Discussioncontrasting

confidence: 59%

Comparison of Surgical Methods in Sacrococcygeal Pilonidal Sinus Treatment

Çantay

Daşdemir²

2021

Journal of Basic and Clinical Health Sciences

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“…On the other hand, wound infection and dehiscence had no effect on disease recurrence in our study but they were risk factors for recurrence in another study. 28 Nevertheless, the small number of patients who experienced wound infection and dehiscence in our study warrants caution in interpreting the results because they are prone to significant type II error.…”

Section: Discussionmentioning

confidence: 75%

Pilonidal sinus disease recurrence at a tertiary care center in Riyadh

et al. 2021

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BACKGROUND: Pilonidal sinus disease (PSD) is a chronic inflammatory disease of the sacrococcygeal area. Pilonidal sinus recurrence is a matter of concern to both patients and healthcare providers. OBJECTIVES: Estimate the rate of PSD recurrence in our center and identify any risk factors contributing to disease recurrence. DESIGN: Retrospective. SETTING: Tertiary care center in Riyadh. PATIENTS AND METHODS: All patients who underwent surgery for primary or recurrent pilonidal sinus between 1 January 2016 to 30 June 2019 were included to allow for at least 1-year of follow-up at the time of data collection. MAIN OUTCOME MEASURE: Recurrence rate of PSD and risk factors for recurrence. SAMPLE SIZE AND CHARACTERISTICS: 369 patients: 329 males (89.2%) and 40 (10.8%) females. Median (interquartile range) age was 21 (18-26) years. RESULTS: Of the 369 included patients, recurrence was identified in 84 (22.8%) cases [95% confidence interval (CI) 18.6-27.4], and the mean timing of recurrence was 1.8 (1.6) years after the primary surgery. In a multivariate logistic regression analysis, increased age and post-operative seroma fluid discharge were independent risk factors for recurrence. In contrast, preoperative antibiotic prophylaxis and postoperative hair removal were effective in reducing recurrence. Type of surgery closure had no effect on recurrence, yet primary closure was associated with early onset of recurrence compared to secondary closure ( P =.02). CONCLUSION: Our findings on the factors associated with recurrence of PSD are consistent with many reports in the literature. Reported prevalence estimates vary widely. LIMITATION: Single center, small sample size, retrospective. CONFLICT OF INTEREST: None.

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“…While wound complications are a major limitation to excisional approaches, Limberg or MLF reconstruction have been previously reported as having the lowest relative risk of wound dehiscence when compared to alternative OMF reconstruction techniques [ 24 ]. Another major concern surrounding wound complications is the subsequent elevated risk of disease recurrence observed after wound dehiscence [ 36 ]. We did observe one case of recurrence after wound dehiscence in the excision/OMF reconstruction cohort, but despite this, the overall recurrence rate in this cohort remained low.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of pediatric pilonidal disease treatment: excision with off-midline flap reconstruction versus endoscopic pilonidal sinus treatment

Lee,

Short,

Zhong

et al. 2024

Pediatr Surg Int

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Purpose Pilonidal disease (PD) is marked by chronic inflammation and frequent recurrence which can decrease quality of life. However, debate remains regarding the optimal treatment for PD in the pediatric population. This study compares two recommended treatment approaches—excision with off-midline flap reconstruction (OMF: Bascom cleft lift flap, modified Limberg flap) and minimally invasive endoscopic pilonidal sinus treatment (EPSiT). Methods Single-center retrospective evaluation of patients 1–21 years of age with PD who underwent either excision with OMF reconstruction or EPSiT between 10/1/2011 and 10/31/2021. Outcomes included were disease recurrence, reoperation, and wound complication rates. Comparisons were performed using Chi-square and Mann–Whitney U tests. Results 18 patients underwent excision/OMF reconstruction and 45 patients underwent EPSiT. The excision/OMF reconstruction cohort was predominantly male (44.4% vs 17.8% p = 0.028), with history of prior pilonidal infection (33.3% vs 6.7%; p = 0.006), and longer median operative time (60 min vs 17 min; p < 0.001). The excision/OMF reconstruction cohort had a higher rate of wound complications (22.2% vs 0%; p = 0.001), but lower rates of disease recurrence (5.6% vs 33.3%; p = 0.022) and reoperation (5.6% vs 31.1%; p = 0.031). Conclusion In pediatric patients with PD, excision with OMF reconstruction may decrease recurrence and reoperation rates with increased operative times and wound complication rates, compared to EPSiT.

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Could Early Postoperative Complications be Considered as Risk Factor for Recurrence after Pilonidal Sinus Surgery?

Cited by 7 publications

References 27 publications

Comparison of Surgical Methods in Sacrococcygeal Pilonidal Sinus Treatment

Comparison of Surgical Methods in Sacrococcygeal Pilonidal Sinus Treatment

Pilonidal sinus disease recurrence at a tertiary care center in Riyadh

Outcomes of pediatric pilonidal disease treatment: excision with off-midline flap reconstruction versus endoscopic pilonidal sinus treatment

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