Abstract
Background
Off-midline closure after excision and primary closure in the treatment of sacrococcygeal
pilonidal disease has been suggested to improve surgical outcomes and reduce median
recurrence rate. The aim of this study was to investigate several features known to
be related to recurrence, allowing adequate comparison of recurrence between D-shaped
asymmetric and symmetric excision in the treatment of sacrococcygeal pilonidal disease.
Methods
An analysis of a prospectively maintained database of 569 surgical excisions performed
for sacrococcygeal pilonidal disease between 1988 and 2007 was performed.
Results
The recurrence rate was lower in the asymmetric (n = 423) than in the symmetric (n
= 101) group (9% vs 22.0%, P = .0001). After a median follow-up period of 11 years, 5-year 10-year, and 20-year
disease-free survival rates were higher in the asymmetric group (94%, 92%, and 89%
vs 84%, 79%, and 71%, respectively, P = .005).
Conclusions
D-shaped asymmetric excision is an effective treatment of sacrococcygeal pilonidal
sinus. Better long-term recurrence rates are achieved compared with symmetric excision,
when stratified for several features known to be related to recurrence.
Keywords
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Article info
Publication history
Published online: October 10, 2013
Received in revised form:
June 20,
2013
Received:
February 3,
2013
Footnotes
Drs Limongelli and Brusciano contributed equally to this work.
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
