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

Abstract

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.

Comparison of different surgical techniques of sacrococcygeal pilonidal sinus disease

“…The maximum hospitalization was in the limberg group. This finding is consistent with literature data (Okuş et al, 2013;Menteş et al, 2008;Uçar et al, 2015).…”

Comparison of limberg flap and oval flap techniques in sacrococcygeal pilonidal sinus disease surgery

“…The patients who were treated with the Limberg and oval flaps in this study were hospitalized for an average of 2 days and then discharged. This finding is similar to that reported in literature (1,6,7).…”

Pi̇loni̇dal Si̇nüs Ameli̇yati Sonrasi Farkli Yatiş Pozi̇syonunun Drenaj Mi̇ktari Üzeri̇ne Etki̇si̇

“…"Pilonidal sinüs" terimi, latincede pilu (kıl) ile nidus (yuva) sözcüklerinden oluşmaktadır (4). Edinsel bir hastalık olduğu kabul edilen pilonidal sinüs hastalığının etiyolojisinde ana faktör kıl olup, natal kleftin kıl foliküllerinin içinden kaynaklanmaktadır (1,5,6). Pilonidal sinüs, inflamatuvar karakterli bir hastalıktır ve ameliyat sonrası yara bakımındaki zorluklar iş gücü kaybına neden olmaktadır.…”