The effect of different surgical methods on complications and on the quality of life in pilonidal sinus disease

Çağlayan, Kasım; Güngör, Bülent; Çınar, Hamza; Topgül, Koray; Kesicioğlu, Tuğrul; Polat, Cafer; Arslan, Nilden

doi:10.5097/1300-0705.ucd.950-11.03

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Data on recurrence and follow-up times pertaining to 12,384 patients treated for PSD by Limberg and Dufourmentel flaps were extracted from 139 additional non-RCTs 4 , 60 , 103 , 104 , 115 , 126 – 128 , 133 , 156 , 157 , 196 , 199 , 201 , 208 , 221 , 224 , 242 , 261 , 262 , 267 , 289 , 302 , 303 , 313 , 318 , 321 , 322 , 334 – 336 , 348 , 372 , 399 , 407 , 410 , 415 , 417 , 426 , 433 , 438 , 439 , 444 – 541 . Among these patients, a recurrence of 0.4% (95% CI 0.3–0.5%) was observed in patients at 12 months, 1.6% (95% CI 1.3–1.9%) at 24 months, 5.2% (95% CI 4.5–5.8%) at 60 months, and 11.4% (95% CI 9.2–13.7%) at 120 months (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Data on recurrence and follow-up times pertaining to 6,366 patients treated for PSD by limited excision PSD treatment were extracted from 71 additional non-RCTs 52 , 61 , 69 , 72 , 73 , 75 , 81 , 83 , 88 , 94 , 106 , 114 , 119 , 121 , 124 , 125 , 131 , 140 , 142 , 144 , 149 , 160 , 208 , 221 , 226 , 248 , 249 , 261 , 285 , 293 , 295 , 319 , 321 , 322 , 400 , 410 , 416 , 536 , 609 , 625 – 656 . Among these patients, a recurrence of 5.0% (95% CI 4.3–5.6%) was observed in patients at 12 months, 6.8% (95% CI 6.0–7.7%) at 24 months, 16.2% (95% CI 14.3–18.2%) at 60 months, and 34.0% (95% CI 26.3–41.6%) at 120 months (Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

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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%

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%

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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“…Sacrococcygeal pilonidal sinus disease (PSD) is characterized by chronic inflammation and recurrent infection. Although it is a benign disease, it can be quite painful, significantly affect quality of life, and cause absence from work and school [13][14][15] For this reason, the number of studies on PSD has increased in recent years. Most of the reported studies are from Mediterranean countries.…”

Section: Discussionmentioning

confidence: 99%

Gender-specific prevalence of sacrococcygeal pilonidal sinus disease in Turkey: A retrospective analysis of a large cohort

Ergenç

Uprak

2022

Eur Surg

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Background Many studies have been carried out to find the optimal treatment for pilonidal sinus disease (PSD), but the gender-specific prevalence in Turkey has not been revealed. Therefore, this article evaluated patients diagnosed with pilonidal sinus disease in our hospital. We aimed to analyze the gender ratio in PSD. Methods We evaluated patients admitted and who underwent pilonidal sinus excision at the Istanbul Sultanbeyli State Hospital between January 2010 and January 2022. Patients with missing data, multiple admissions, and multiple surgeries of the same patient were excluded from the analyses. Patients were stratified according to age into two groups: < 18 (teenage) and ≥ 18 (adult). Age and gender, diagnosis at admission, and operation status were analyzed. Results A total of 10,324 PSD patients were analyzed. 24.8% (n = 2559) of the patients were female and 75.2% (n = 7765) were male. Patients' ages ranged from 13 to 86 years; the mean age was 26.5 years. Of all patients, Availability of data and material The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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The effect of different surgical methods on complications and on the quality of life in pilonidal sinus disease

Cited by 3 publications

References 14 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

Gender-specific prevalence of sacrococcygeal pilonidal sinus disease in Turkey: A retrospective analysis of a large cohort

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