Timeline of Recurrence After Primary and Secondary Pilonidal Sinus Surgery

Doll, Dietrich; Krueger, C. M.; Schrank, Stefan; Dettmann, Heidi; Petersen, Sven; Duesel, Wolfgang

doi:10.1007/s10350-007-9031-4

Cited by 132 publications

(114 citation statements)

References 25 publications

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“…Its prevalence is 1-4 per 25000 population, with a 40% five-year recurrence rate (1)(2)(3). Approximately 70% of PSD patients are between 20-30 years of age (4).…”

Section: Introductionmentioning

confidence: 99%

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Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Uçar¹,

Cartı²,

Oymacı³

et al. 2016

UCD

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Objective: Pilonidal sinus disease (PSD) effects mainly young men's social and work life with frequent recurrence rate. Reoperation for unimproved or recurrent disease is somehow troublesome. Surgeons may think that changing treatment strategy after recurrence may prevent further relapses of PSD. We analyzed patients with recurrent pilonidal sinus to determine their predisposing features for recurrence and the outcomes of the preferred surgical methods. Material and Methods:From 2007 to 2012, out of 95 recurrent pilonidal sinus disease (rPSD) patients, 62 operated cases were included and examined retrospectively. Their retrospective data were examined for demographics, 1 st and 2 nd operation types, patient satisfaction and pain scores. For cases with insufficient preoperative or postoperative data, phone call and interviews were done to obtain data. Some were kindly invited to the outpatient examination. Student's t test, Mann-Whitney U test, and Kaplan Meier test for disease free survival time were used where appropriate. P values less than 0.05 were accepted to be statistically significant. Results:Total of 62 rPSD patients were examined. Male:female ratio was 2.9:1. The mean age after 1 st and 2 nd operations were 24.7 and 28.1 years, respectively. One and five-year recurrence rates were 33.9% and 66.1%, respectively. The mean interval between the 1 st and 2 nd operations was 45.6 months. Excision and midline closure was the most frequent type of operation followed by flap reconstructions and excision-lay open procedures. The 1 st operation types of rPSD cases were different from that of 2 nd operations. Pain perception and satisfaction scores were better in flap reconstruction groups. Conclusion:Reoperative surgery of rPSD is satisfactory with certain precautions. Relapses after flap reconstruction procedures with a well-being period should be referred as second primary disease. Changing surgical strategy is not always indicated as some patients with recurrence have relapsing or second primary disease that have distinct clinical course. Re-flap surgery after any kind of relapse is well appreciated.

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“…Its prevalence is 1-4 per 25000 population, with a 40% five-year recurrence rate (1)(2)(3). Approximately 70% of PSD patients are between 20-30 years of age (4).…”

Section: Introductionmentioning

confidence: 99%

“…Risk factors include obesity, smoking, poor hygiene, sedentary life style, African race, family history, and high amount of hair on the body. The recurrence rates for PSD after lay open and primary closure techniques are 17% and 30%, respectively (1). Primary closure techniques are divided into two main categories.…”

Section: Introductionmentioning

confidence: 99%

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Uçar¹,

Cartı²,

Oymacı³

et al. 2016

UCD

View full text Add to dashboard Cite

show abstract

“…In a study of 205 military patients followed for a median of 14.8 years, Doll et al found a bimodal peak of disease recurrence following excision and primary closure with early recurrences occurring in the first four years. 26 They suggested that a follow-up duration of at least five years is required to detect 75% of recurrences.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap

Venus

Titley

2012

annals

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Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap MR Venus, OG Titley University Hospitals Birmingham NHS Foundation Trust, UK aBsTraCT INTRODUCTION The ideal treatment for pilonidal sinus disease has yet to be defined. There are many approaches described in the literature. METHODS Thirty-five consecutive patients who underwent wide excision of pilonidal sinus disease had the wound repaired using a parasacral perforator flap. Outcomes were assessed by case notes analysis and follow-up telephone and postal questionnaires. RESULTS There were ten minor complications including six minor wound edge dehiscences. There were two ischaemic complications, with one flap loss. There were 3 recurrences of pilonidal disease at a mean follow-up of 33 months, giving a 5-year recurrence free rate of 86%. Of the patients questioned, all would recommend the procedure to someone else despite 69% being dissatisfied with the cosmetic outcome. CONCLUSIONS This series indicates that the parasacral perforator flap technique is able to repair pilonidal sinus excision wounds successfully with minimal morbidity and a low recurrence rate at a mean of follow-up of 33 months. The study suggests that it may be a technique best reserved for recurrent cases of pilonidal sinus disease. Patients feel the procedure is successful despite reservations regarding the cosmetic outcome.

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“…However, in the minimal surgical procedure recurrence, rates increased over the span of a year (7). Many publications have shown that recurrence occurred in the first 5 years (19)(20)(21). Soll et al demonstrated that recurrence rates for PS treated with the minimal surgical procedure increased annually, and they gave the recurrence rates as 6.5%, 13.2%, and 16.2% for the first year, the first 5 years, and the first 10 years, respectively (7).…”

Section: Discussionmentioning

confidence: 99%

Comparison of results of minimal invasive surgery for pilonidal sinus with karydakis procedure: less is more

Özyıldız¹,

Yazıcıoğlu²,

Coşkun³

et al. 2017

J Turgut Ozal Med Cent

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Aim: Controversy still remains regarding the best surgical technique to use for the treatment of pilonidal disease to minimize disease recurrence and patient discomfort. Minimal surgical procedures can be performed on an outpatient basis. In this study, the early results of our minimally invasive operative approach cases are compared with Karydakis flap reconstruction results. Material and methods: From January 11, 2012 to January 23, 2013, 312 patients were diagnosed with pilonidal sinus and treated in our clinic. Eighty-two of these patients (35 treated by a minimally invasive procedure (group I), 47 by the Karydakis flap procedure [Group II]) were included in the study. Data were collected by reviewing the patients' records and by conducting telephone interviews. Results:The follow-up time of each case for Group I was 35 months and the average follow-up time was 32.5 months for Group II (interval, 24-40 months). Group I patients returned to work in 1 day; however, 40 patients (85.1%) in Group II returned in 20 days and 7 (14.9%) returned to work in 30 days. In group I, 32 patients (94%) were satisfied and 2 patients (5.7%) were not satisfied. In Group II, 32 patients (68.1%) were satisfied with the results of the surgical procedure and 15 patients (31.9%) were not satisfied. Our recurrence rates for group I and II were 5.7% and 6.4% for the first year, respectively. Conclusion: This indicated that the minimally invasive operative procedure can be performed with a low recurrence rate on a one day outpatient basis.

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Timeline of Recurrence After Primary and Secondary Pilonidal Sinus Surgery

Cited by 132 publications

References 25 publications

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap

Comparison of results of minimal invasive surgery for pilonidal sinus with karydakis procedure: less is more

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