Room for Improvement: The Trephination Procedure for Pediatric Patients with Pilonidal Disease

Metzger, Gregory A.; Apfeld, Jordan C.; Nishimura, Leah; Beyene, Addisu Shunu; Lutz, Carley; Deans, Katherine J.; Minneci, Peter C.

doi:10.1016/j.jss.2021.06.010

Cited by 11 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12,13 In addition, only very few studies, as of today, sought to determine recurrence rates, following this procedure, in the pediatric population. 14,15 Of the scarce data published on this topic, it was demonstrated that there was a high recurrence rate of 16.1% at 6-month among children undergoing trephination, and approximately 15% required a second surgery, [16][17][18] although it is a promising technique with better postoperative functional outcome and better healing process. 19 In this retrospective study, we aimed to investigate recurrence rates of PSD amongst pediatric patients who underwent the Gips procedure, as well as to determine whether this method should be also recommended upon further recurrences.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, only very few studies, as of today, sought to determine recurrence rates, following this procedure, in the pediatric population 14,15 . Of the scarce data published on this topic, it was demonstrated that there was a high recurrence rate of 16.1% at 6‐month among children undergoing trephination, and approximately 15% required a second surgery, 16–18 although it is a promising technique with better postoperative functional outcome and better healing process 19 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Recurrence rates of pilonidal sinus disease in the pediatric population following trephine surgery

Dreznik,

Sher,

Baazuv

et al. 2024

World j. surg.

View full text Add to dashboard Cite

BackgroundPilonidal sinus disease (PSD) is a common surgical disease. Multiple surgical methods exist in the literature, without clear consensus regarding which should be the first‐line treatment. Minimally invasive methods such as the Gips procedure are gaining popularity in recent years. The aim of our study was to assess recurrence rates following the Gips procedure and to determine whether using the same surgical approach during re‐operation is efficient and successful.MethodsThis is a single‐center retrospective observational study of pediatric patients that underwent Gips procedure due to PSD between the years 2012–2022.Results565 pediatric patients underwent an elective surgery for PSD in the study period. Recurrence rate was 8.1% (n = 46). In all the patients with recurrence, re‐operation took place on average 9 months following the first surgery and using the same surgical method. Following the second surgery, only 8 patients (1%) had multiple recurrences.ConclusionsWe found a relatively low recurrence rate in the pediatric population using the Gips method, and nearly 100% success rate following the second operation. Our findings set a new benchmark for pediatric recurrence following PSD operation, with clear recommendation to use the same method of surgery upon further recurrences as well.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Recurrence rates of pilonidal sinus disease in the pediatric population following trephine surgery

Dreznik,

Sher,

Baazuv

et al. 2024

World j. surg.

View full text Add to dashboard Cite

show abstract

“…Our patient was asymptomatic when first presented to the clinic and was successfully managed with regular epilation without operative management for the duration of her second and third trimesters. Management of pilonidal disease often involves surgical excision in order to prevent recurrence [ 5 , 6 ]. Our case demonstrated that asymptomatic pilonidal disease can first be managed non-operatively.…”

Section: Discussionmentioning

confidence: 99%

Pilonidal disease in the pregnant patient: A case report

Liang,

Abrajano,

Chiu

2024

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

“…The sample size of this study was insufficient and the follow-up time was short, thus more research is still needed to verify the findings. Another retrospective study the same year found that the technique achieved a recurrence rate of 16.1% within 6 months after surgery; however, the study only had 19 subjects and the postoperative follow-up time was short, so a long-term study with a large sample is needed for verification 125 . In 2022 a retrospective study by Diéguez et al 126 verified the advantages of Gips surgery in children, but the short follow-up time was problematic.…”

Section: Discussionmentioning

confidence: 99%

Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review

Zhang

Wang

2023

International Journal of Surgery

View full text Add to dashboard Cite

Background: A pilonidal sinus (PS) is an acquired disease resulting from recurrent infections and chronic inflammation. A PS involving the sacrococcyx is referred to as a sacrococcygeal PS (SPS). An SPS is a rare chronic infectious disease for which surgery is a good choice. The incidence of SPS has gradually increased worldwide in recent years. However, surgeons have not reached a consensus on the preferred surgical approach for SPS. The authors performed a systematic review and meta-analysis to analyze differences in the efficacy of different surgical approaches for the treatment of SPS. Methods: A systematic search was conducted in the PubMed database covering the period from 1 January 2003, to 28 February 2023. The primary outcome parameters were recurrence and infection. Finally, statistical analysis (meta-analysis) was carried out using RevMan 5.4.1 software. In addition, we systematically reviewed the latest progress in the surgical treatment of SPS over the past 20 years, especially as reported in the past 3 years. Results: Twenty-seven articles, 54 studies, and 3612 participants were included in this meta-analysis. The recurrence rate following the midline closure (MC) technique was much higher than that of other techniques. Among the techniques analyzed, the differences between MC and Limberg flap (LF), and between MC and marsupialization were statistically significant [P=0.0002, risk ratio (RR)=6.15, 95% CI 2.40, 15.80; P=0.01, RR=12.70, 95% CI 1.70, 95.06]. The recurrence rate of open healing was higher than that of the Karydakis flap (KF) technique, and the difference was statistically significant (P=0.02, RR=6.04, 95% CI 1.37, 26.55). Most of the results comparing MC with other techniques suggested that the former had a higher infection rate, and the difference between MC and LF was statistically significant (P=0.0005, RR=4.14, 95% CI 1.86, 9.23). Comparison between KF and LF, modified LF and KF showed that the differences were not statistically significant in terms of recurrence and infection (P≥0.05). Conclusions: There are various surgical treatment options for SPS, including incision and drainage, excision of diseased tissue with primary closure and secondary healing, and minimally invasive surgery. It is still not possible to determine which surgical technique should be considered the gold standard for treatment, as even the results of different researchers using the same operation method are conflicting. But what is certain is that the midline closure technique has a much higher incidence of postoperative recurrence and infection than other techniques. Therefore, the anorectal surgeon should formulate the most suitable individualized plan for the patient based on a comprehensive evaluation of the patient’s wishes, appearance of the SPS, and the professional ability of the surgeon.

show abstract

Room for Improvement: The Trephination Procedure for Pediatric Patients with Pilonidal Disease

Cited by 11 publications

References 28 publications

Recurrence rates of pilonidal sinus disease in the pediatric population following trephine surgery

Recurrence rates of pilonidal sinus disease in the pediatric population following trephine surgery

Pilonidal disease in the pregnant patient: A case report

Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review

Contact Info

Product

Resources

About