Long-term results of a randomized clinical trial comparing endoscopic versus conventional treatment of pilonidal sinus

Milone, Marco; Velotti, Nunzio; Manigrasso, Michele; Vertaldi, Sara; Lauro, Katia Di; Simone, G.; Cirillo, Vera; Maione, Francesco; Gennarelli, Nicola; Fernandez, Loredana Maria Sosa; Palma, Giovanni Domenico De

doi:10.1016/j.ijsu.2019.12.033

Cited by 37 publications

(47 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We excluded 177 duplicated articles, meta-analysis and systematic review (n = 16), and 137 other articles because of irrelevant topics (n = 67). However, Milone 12 , 16 et al published two papers reporting the same clinical trial in 2020 and 2016. We only included the one in 2020 to gain results from a longer follow-up duration.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis

Sun

Chen

et al. 2020

Sci Rep

View full text Add to dashboard Cite

The most appropriate surgical treatment for pilonidal sinus disease (PSD) is still in dispute. This study aims to comprehensively compare the outcomes of surgical interventions using network meta-analysis. Randomized controlled trial studies were searched systematically to identify all eligible studies in multiple databases and previous publications and Bayesian network meta-analysis was performed. Our primary outcome was the recurrence rate. Differences in the findings of the studies were explored in meta regressions and sensitivity analyses. The risk of bias of each study was assessed using the Cochrane risk of bias tool. Confidence in evidence was assessed using CINeMA (Confidence in Network Meta-Analysis). A total of 39 studies and 5,061 patients were identified and the most common surgical intervention was the Limberg flap. In network meta-analysis, modified Limberg flap and off-midline closure were associated with the lowest recurrence rate. However, the Karydakis flap was associated with shorter operation time by several minutes compared with other interventions and few significant results were found in other outcomes. Modified Limberg flap and off-midline closure provided relatively low recurrence and complications rates. Therefore, they could be two promising surgical interventions for PSD patients.

show abstract

Section: Resultsmentioning

confidence: 99%

“…We only included the one in 2020 to gain results from a longer follow-up duration. In the end, a total of 39 controlled studies with 5,061 participants were included for this meta-analysis 7 , 9 , 16 – 52 . The detailed classification and definition of treatments are documented in Supplementary Table S1 .…”

Section: Resultsmentioning

confidence: 99%

Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis

Sun

Chen

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…However, until now, few RCTs have compared these minimally invasive techniques vs. time-honored standard surgical treatments [44][45][46].…”

Section: The Most Appropriate Surgical Treatment Of Chronic Pd Sinus Is Controversial (1b)mentioning

confidence: 99%

“…While comparing both short-and long-term outcomes of video-assisted ablation of pilonidal sinus (VAAPS) vs. Bascom "cleft lift", Milone et al [45,46] demonstrated that VAAPS was associated with shorter time off work and lower postoperative infection rates, less pain, and higher patient satisfaction, with a comparable 5-year recurrence rate. Finally, a study compared sinusectomy and endoscopic treatment [47], showing that endoscopy was associated with a recurrence rate lower than sinusectomy, but overlapping postoperative pain and patient satisfaction.…”

Section: The Most Appropriate Surgical Treatment Of Chronic Pd Sinus Is Controversial (1b)mentioning

confidence: 99%

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease

et al. 2021

View full text Add to dashboard Cite

Pilonidal disease (PD) is a relatively common, benign but challenging condition of the natal cleft. This consensus statement was drawn up by a panel of surgeons, identified by the Italian Society of Colorectal Surgery (SICCR) as having a “special interest” in PD, with the aim of recommending the best therapeutic options according to currently available scientific evidence. A three-step modified-Delphi process was adopted, implying: (1) choice of the panelists; (2) development of a discussion outline and of target issues; and (3) a detailed systematic review of the current literature. The agreement/disagreement level was scored on a five-point Likert scale as follows: “A + : strongly agree; A–: agree; N: unsure/no opinion; D–: disagree; D + : strongly disagree. Each panelist contributed to the production of this manuscript, and the final recommendations were reviewed by the Clinical Practice Guidelines Committee.

show abstract

“…In a randomised trial of 145 patients comparing VAAPS with Bascoms procedure showed reduced time off work, less pain and greater patient satisfaction allbeit recurrence at 1-year and post-operative complications were similar between the 2 groups [ 65 ]. Furthermore, 5-year followup of these patients revealed a similar long-term recurrence rate between VAAPS and Bascoms procedure, with VAAPS being more cost-effective and leading to better patient satisfaction [ 66 ]. An interesting variation of this technique was the endoscopic application of crystalized phenol, which showed no recurrence in 23 patients at 24 months [ 67 ].…”

Section: The Future Of Pilonidal Sinus Surgery: the Shift Towards Endmentioning

confidence: 99%

Pilonidal sinus disease: Review of current practice and prospects for endoscopic treatment

Mahmood

Hussain

Akingboye

2020

Annals of Medicine and Surgery

View full text Add to dashboard Cite

Pilonidal sinus disease is chronic acquired condition leading to significant morbidity and associated healthcare costs. Several techniques have been described to manage this condition with no treatment gaining universal acceptance. With the shift towards minimally invasive surgery, Video Assisted-Ablation of Pilonidal Sinus (VAAPS) and Endoscopic Pilonidal Sinus Treatment (EPiST) have gained prominence. The aim of this review is to analyse current treatment modalities and the evidence for endoscopic pilonidal sinus surgery. Reported surgical techniques range from wide excision with or without primary closure to various flap closures. These aim to eliminate the underlying causes driven by natal cleft hair and reducing recurrence. However, long term (≥5 years) recurrence rates range between 10 and 30% with significant complication rates. Trials with endoscopic treatment which have shown comparable short-term results to established treatments with reduced morbidity. However, the potential higher cost, learning curve, patient selection criteria and need for long term outcomes from randomised trials limit widespread application of this promising method. Endoscopic treatment of pilonidal sinus disease therefore provides a minimally invasive alternative to traditional surgical methods with the potential to reduce morbidity. However long-term outcomes data from further prospective randomised trials is needed to establish its efficacy compared to traditional surgical methods.

show abstract

Long-term results of a randomized clinical trial comparing endoscopic versus conventional treatment of pilonidal sinus

Cited by 37 publications

References 19 publications

Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis

Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease

Pilonidal sinus disease: Review of current practice and prospects for endoscopic treatment

Contact Info

Product

Resources

About