Oblique excision with primary closure for the treatment of pilonidal sinus

Talu, M.; Ycel, O.; User, Yılmaz; Dede, Anastasia D; nder, H.; Tolun, S.

doi:10.1007/bf00176279

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Further, data on recurrence and follow-up times pertaining to 3,121 patients receiving primary open PSD treatment were extracted from 28 additional non-RCTs 4 , 76 , 130 , 133 , 139 , 157 , 221 , 228 , 320 , 348 , 357 , 375 – 391 . Among these patients, a recurrence of 1.0% (95% CI 0.6–1.4%) was observed in patients at 12 months, 1.6% (95% CI 1.1–2.1%) at 24 months, 3.2% (95% CI 2.3–4.0%) at 60 months, and 6.7% (95% CI 5.2–8.2%) at 120 months (Fig.…”

Section: Resultsmentioning

confidence: 99%

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Stauffer

Luedi

Kauf

et al. 2018

Sci Rep

203

191

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We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure.

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Section: Resultsmentioning

confidence: 99%

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Stauffer

Luedi

Kauf

et al. 2018

Sci Rep

203

191

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“…at riskRR in % (95% CI)Nr. at riskPrimary open (143)2.7* (0.0–5.5)143*5.9* (1.4–10.4)120*NANANANA 32, 114, 118 Primary median closure (2902)0.8 (0.4–1.1)28187.0* (5.7–8.2)1383*18.8* (15.7–21.8)417*NANA 118, 127, 133, 136, 137, 139, 143, 148, 149, 158– 160, 169, 172– 174, 183, 192, 199– 201, 232, 242, 243, 246, 247, 597– 603 Primary asymmetric closure (727)1.7 (0.7–2.8)6212.5 (1.1–3.8)4037.4 (4.4–10.4)257NANA 183, 192, 253, 259, 261, 262 Karydakis/Bascom (2471)0.8 (0.4–1.1)23561.7* (1.1–2.4)1343*10.7 (7.4–13.9)257NANA 133, 172, 192, 199, 200, 262, 264, 267, 268, 270, 273, 274, 276, 279, 282, 284, 289– 292, 295, 296, 300, 305– 309, 603 Limberg/Dufourmentel (7653)0.1 (0.0–0.2)73691.1 (0.8–1.4)…”

Section: Resultsmentioning

confidence: 99%

“…at riskRR in % (95% CI)Nr. at riskPrimary open (6351)1.3 (1.0–1.7)57154.2 (3.6–4.8)349613.9 (12.2–15.6)122228.1* (23.9–32.4)241* 20– 122 Primary median closure (15011)3.1 (2.8–3.5)12,4848 (7.4–8.6)695614.9 (13.8–15.9)250527.9 (25.5–30.4)631 20, 24, 27, 29, 31, 34– 38, 44, 46, 48, 52, 54, 56, 57, 59, 61– 66, 69, 73– 78, 81– 84, 86, 89– 91, 93– 100, 106– 108, 115, 118, 122– 248 Primary asymmetric closure (2538)0.6 (0.3–0.9)24321.1 (0.7–1.6)18072.7 (1.9–3.6)12056.3* (4.8–7.7)937* 65, 67, 100, 129, 183, 192, 249– 263 Karydakis/Bascom (6276)0.5 (0.3–0.7)58681.6 (1.2–2.0)36306.3 (5.0–7.5)853NANA 16, 21, 29, 41, 49, 66, 78, 88, 133, 163, 172, 184, 189, 192, 195, 199, 200, 202, 262– …”

Section: Introductionmentioning

confidence: 99%

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Doll

Orlik

Maier

et al. 2019

Sci Rep

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Pilonidal sinus disease (PSD) is increasing globally. A recent meta-analysis and merged-data analysis showed that recurrence rates in PSD depend essentially on follow-up time and specific surgical procedures. However, the global distribution of surgical approaches and respective recurrence rates have never been studied in PSD. We aimed at studying the impact of geographic distribution of surgical approaches to treat PSD and subsequent geography-specific recurrence rates. We searched relevant databases as described previously. Recurrence rates were then associated with reported follow-up times and geographic origin. We simulated individual patients to enable analogy across data. Globally, recurrence rates range from 0.3% for Limberg/Dufourmentel approaches (95% CI 0.2–0.4) and flaps (95% CI 0.1–0.5) and up to 6.3% for incision (95% CI 3.2–9.3) at 12 months. Recurrence rates range from 0.3% for Karydakis/Bascom approaches (95% CI 0.0–0.8) up to 67.2% for incision (95% CI 7.5–100) in the USA, and 0.0% for primary asymmetric closure in Germany (95% CI 0.0–0.0). Our analysis shows that recurrence rates in PSD not only depend on therapeutic approaches and follow-up time but also on geography. Primary asymmetric closure and various flap techniques remain superior regardless of the geographical region. Some approaches have extraordinarily good outcomes in specific countries.

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Pilonidal Sinus

Deléaval¹

1998

Surgical Management of Anorectal and Colonic Diseases

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Oblique excision with primary closure for the treatment of pilonidal sinus

Cited by 4 publications

References 23 publications

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Pilonidal Sinus

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