Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease: a randomized-controlled trial

Pronk, A. A.; Smakman, Niels; Furnée, Edgar J.B.

doi:10.1007/s10151-019-02030-w

Cited by 11 publications

(18 citation statements)

References 26 publications

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“…The benefits of phenolisation are due to the minimal invasive character; smaller wounds leading to less postoperative pain and quicker skin epithelization at the natal cleft. The benefits of phenolisation have been reported before in patients treated for primary SPSD, but not for patients who presented with recurrent SPSD [4]. Our current study showed that phenolisation of the sinus tract in patients with recurrence SPSD is safe as no major perioperative complications occurred along with only an SSI rate of 9%.…”

Section: Discussionsupporting

confidence: 54%

“…Comparing the loss of days of daily activities after phenolisation in patients with recurrent SPSD and patients with primary SPSD showed comparable results (five days vs. five days, respectively) [4]. Two previous studies investigated crystallized phenol in patients with recurrent SPSD.…”

Section: Discussionmentioning

confidence: 77%

“…Phenolisation is a minimally invasive treatment modality for patients with symptomatic primary chronic SPSD that has shown to be safe and effective in patients with primary SPSD. Two randomized trials comparing phenol application and excision for primary SPSD have been performed so far, showing lesser postoperative pain, faster return to normal daily activities, quicker wound healing as well as equal surgical site infection and recurrence rates after phenolisation [3][4]. Several additional cohort studies on phenol application on primary SPSD have been published showing comparable results.…”

mentioning

confidence: 99%

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Phenolisation of the Sinus Tract in Recurrent Sacrococcygeal Pilonidal Sinus Disease: A Prospective Cohort Study

Pronk

Vissink

Smakman

et al. 2020

Cureus

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Phenolisation is a minimally invasive treatment option in patients with primary pilonidal disease. However, most studies focus on patients with primary pilonidal sinus disease, while data of patients with recurrent pilonidal disease are very scarce. The purpose of this study was to evaluate phenolisation of the sinus tract in patients with recurrent pilonidal sinus disease after previous surgery for SPSD. Methods This single-center prospective cohort study included 60 patients with recurrent pilonidal disease. Loss of days of normal daily activities, surgical site infection, wound epithelization, quality of life, and complaints related to pilonidal disease were postoperatively assessed. Results A total of 57 patients (95%) were treated with phenolisation and the median loss of days of normal daily activities was 5.0 (1.0-12.0) days. Fifty-one patients (89.5%) resumed normal daily activities after two weeks. Surgical site infection occurred in five patients (8.8%). Compared to preoperative scores, quality of life was significantly higher 12 weeks postoperatively (p=0.014) and pain and itch scores were lower after six and 12 weeks (p ≤ 0.005). Wounds were completely healed in 45 of 51 patients (89.8%) who were available after 12 weeks of follow-up. Conclusion Phenolisation for recurrent pilonidal disease is safe with a median complete return to daily activities within five days and complete wound healing after three months in 90%. Therefore, phenolisation should be considered as a treatment option in patients with recurrent pilonidal sinus disease.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 77%

mentioning

confidence: 99%

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Phenolisation of the Sinus Tract in Recurrent Sacrococcygeal Pilonidal Sinus Disease: A Prospective Cohort Study

Pronk

Vissink

Smakman

et al. 2020

Cureus

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“…14 In a randomized-controlled trial, Pronk et al compared short-term outcomes of radical excision vs. phenolization methods in the treatment of PSD. 27 Because the diff erences between above mentioned techniques in terms of recurrence and thus, success rate are small, no definitive conclusion can be drawn from these results. Th erefore, large-scale comprehensive studies are needed to find an ideal or optimal method for the treatment of PSD.…”

Section: Figure 1 Risk Factors For Disease Free Survival (Dfs)mentioning

confidence: 96%

Fenolizasyon ve SILaC Lazer: Pilonidal Sinüs Hastalığının Tedavisinde Hangisi Daha Başarılı?

Uzunoğlu¹,

Yalkın²

2022

Sakarya Medical Journal

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Objective: In this study we aimed to compare phenol application and sinus laser-assisted closure (SiLaC) methods for the treatment of pilonidal sinus disease (PSD). Materials and Methods: A total of 141 patients were divided into two groups with 73 patients being in the phenol group and 68 patients in the laser group. Patients’ demographic characteristics, smoking status, presence of co-morbidities, history of abscess drainage, previous PSD surgery, recurrence status, need for re-operation, postoperative complications, distance of orifice from the midline and number of sinus tract were retrospectively recorded and compared between the groups. Results: No statistically significant difference was observed between the two groups in terms of demographic features and disease free survival (DFS). DFS was statistically significantly shorter in the patients with previous pilonidal sinus surgery, in smoker patients and in the patients with complications. Recurrence rate was similar between both groups. Previous pilonidal sinus surgery, smoking and complications are the factors affecting disease free survival. Number of sinus tracts and distance of the orifice to the midline are the factors affecting recurrence. According to the ROC curve analysis, a cut-off value for orifice distance >1.4 cm predicted the development of recurrence sensitivity 100%, specificity 92.91%. Conclusion: The results of this study indicate that recurrence and success rates are similar between the relatively newer SILaC method and phenolization technique. Rate of complications is also similar. Both treatment methods can be safely and effectively used for the treatment of PSD.

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“…In addition, after surgical excision, a high rate of wound complications leads to prolonged healing time and, as a result, a more extended return to regular activities. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis on the effect of the endoscopic versus conventional treatment for pilonidal sinus: A meta-analysis of controlled clinical trials

et al. 2022

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Background: Pilonidal sinus is a common disease in the sacrococcygeal region. Although many treatments have been described in recent years, the recurrence of each method remains high. Surgeons did not reach a consensus on the preferred approach for pilonidal sinus. We carried out a meta-analysis of controlled clinical trials comparing the outcomes of endoscopic treatment versus conventional treatment for pilonidal sinus disease in this study.Methods: We performed a systematic literature search, and we used electronic databases such as PubMed/Medline, Embase, and the Cochrane library to search for the relevant literature comparing endoscopic management to other conventional treatments for pilonidal sinus disease. The primary outcome parameters were operative time, recurrence, postoperative complications and pain, and total healing time.Results: Six studies were included in the review. Endoscopic pilonidal sinus treatment had a lower overall complication rate than the conventional surgery group (risk ratio = 0.33 [0.19-0.58], P = .0001) and lower pain score with a weighted mean difference of −2.44 (95% confidence interval: (−3.96) to (−0.92), I 2 = 99%, P = .002). There was no significant difference in recurrence (risk ratio = 0.75, 95% confidence interval [0.30-1.90],P = .55). Compared to the excision followed by the primary closure technique, the operation time, time to complete wound healing, and satisfaction were similar.Conclusions: Endoscopic pilonidal sinus treatment is a unique and potential method of sacrococcygeal pilonidal disease treatment. The foremost benefits of this technique are mild postoperative pain, lower complications rate, and return to routine for a shorter time. However, due to the limited number of articles, we need to conduct more rigorous large-sample prospective randomized controlled trials to clarify the efficiency of endoscopic treatment for pilonidal cysts.Abbreviations: CI = confidence interval, EHSI = en-bloc excision and healing by secondary intention, EPC = excision and primary closure, EPSiT = endoscopic pilonidal sinus treatment, ERAS = enhanced recovery after surgery, NA = Not available, PSD = pilonidal sinus disease, RCT = randomized controlled trial, RR = risk ratio.

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Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease: a randomized-controlled trial

Abstract: Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease Pronk, A. A.; Smakman, N.; Furnee, E. J. B.

Cited by 11 publications

References 26 publications

Phenolisation of the Sinus Tract in Recurrent Sacrococcygeal Pilonidal Sinus Disease: A Prospective Cohort Study

Phenolisation of the Sinus Tract in Recurrent Sacrococcygeal Pilonidal Sinus Disease: A Prospective Cohort Study

Fenolizasyon ve SILaC Lazer: Pilonidal Sinüs Hastalığının Tedavisinde Hangisi Daha Başarılı?

Comparative analysis on the effect of the endoscopic versus conventional treatment for pilonidal sinus: A meta-analysis of controlled clinical trials

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