Minimally invasive surgery for the treatment of pilonidal disease. The Gips procedure on 2347 patients. (December 2016)

• Record Type: Journal Article
• Authors: Di Castro, Angelo; Guerra, Francesco; Levi Sandri, Giovanni Battista; Ettorre, Giuseppe Maria
• Is Part Of: International journal of surgery. Volume 36:Part A(2016)
• Page Start: 201
• Page End: 205
• Publication Date: 2016-12
• Subjects: Pilonidal disease -- Trephines -- Minimally invasive surgery; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2016.10.040
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: Pilonidal disease is a quite common chronic inflammatory disease that causes discomfort, embarrassment and absence from work or school. In line with its acquired pathogenesis, a number of surgical alternatives to conventional en bloc excision have been proposed over the last decades, yielding encouraging results. We reviewed our experience with minimally invasive sinusectomy to evaluate its safety and efficacy. Methods: this study was a review of a prospectively maintained database of consecutive patients over a 7-year period. From November 2009 to December 2015, 2347 patients with pilonidal disease were operated on using the Gips procedure. Patients received surgery as a day-case procedure under local anesthesia. Operative and perioperative data were examined. Results: there were 1714 men (73%) and 633 women (27%) in the study; the median age was 19 years. Recurrent diseases in patients who had previously undergone surgery elsewhere composed 61% of cases. Globally, 102 cases of clinically relevant postoperative complication occurred (4.3%). At a median follow up of 16 months, the recurrence rate was 5.8%. The treatment of recurrent disease did not correlate to increased recurrence rate following sinusectomy. Recurrent patients were more likely to be male and have delayed wound healing. Conclusions: the Gips procedure for the treatment of pilonidal disease is safe and feasible. It has a low complication and recurrence rate, early return to daily activities and offers a good cosmetic result. Highlights: According to its acquired pathogenesis, a number of minimally invasive procedures have been proposed over the last decade to treat pilonidal disease. Although not widely used, sinusectomy has shown encouraging results in a few reports worldwide. On a large series of consecutive patients, our experience confirms sinusectomy as a safe and effective procedure for both primary and recurrent pilonidal disease. Sinusectomy combines the well-known advantages of a less invasive technique while assuring limited rates of complications and recurrence.