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Five-year recurrence after endoscopic approach to pilonidal sinus disease: A multicentre experience

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Abstract

Purpose

The aim of this study was to evaluate the 5-year recurrence rate of pilonidal sinus disease (PSD) after endoscopic sinusectomy and identify risk factors for recurrence.

Methods

All consecutive patients from September 2011 through December 2017 who underwent endoscopic sinusectomy at seven referral centres for pilonidal sinus treatment were retrospectively analysed from a prospectively maintained database.

Results

Out of 290 patients (185 males versus 105 female, with a mean age of 25.5±6.9), 73 presented recurrence at 5-year follow-up with a recurrence rate of 25.2%. The number of pilonidal sinus with pits off the midline (p = 0.001) and the mean (SD) distance from the most lateral orifice to the midline (p = 0.001) were higher in the group of patients with recurrence at 5-year follow-up. Multivariate analysis demonstrated that the position of the pits off the midline (p = 0.001) and the distance of the most lateral orifice from the midline (p = 0.001) were independent risk factors for recurrence at 5-year follow-up. Receiver operating characteristic (ROC) curve analysis showed that the distance of lateral orifice from midline predicted an 82.2% possibility of recurrence at 5-year follow-up and Youden’s test identified the best cut-off as 2 cm for this variable. Out of 195 cases with the most lateral orifice less than 2 cm from the midline, 13 presented recurrence at 5-year follow-up with a recurrence rate of 6.7%. Out of 95 cases with the most lateral orifice more than 2 cm from midline, 60 showed recurrence at 5-year follow-up with a recurrence rate of 63.2%.

Conclusions

This data may help guide which disease characteristics predict the optimal use of an endoscopic pilonidal sinus technique.

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Data availability

Data are available under request to the corresponding author.

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Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, “Federico II” University of Naples, Naples, Italy

    M. Manigrasso

  2. Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples, Italy

    A. D’Amore, G. D. De Palma & M. Milone

  3. Proctology Unit, ASL 4 Chiavarese, “E. Riboli” Hospital, Lavagna, GE, Italy

    E. Benatti, L. Mori & M. Pezza

  4. Department of Biomedical Sciences, Humanitas University, Milan, Italy

    L. M. Bracchitta

  5. Coloproctolgy Center, Clinica del Mediterraneo, Ragusa, Italy

    S. Bracchitta

  6. Centro Proctologico e Perineologico, Ospedali Privati Forlì, Forlì, Italy

    F. Cantarella, E. Magni & P. Vanini

  7. Department of Health Sciences, University of Catanzaro, Catanzaro, Italy

    A. Carpino, F. Ferrari & G. Gallo

  8. Department of Surgery, Sapienza University of Rome, Rome, Italy

    G. Gallo & M. La Torre

  9. Department of Surgery, AUSL of Imola (BO), Bologna, Italy

    C. Magnani, A. Margiotta & M. Masetti

  10. Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, CS, Italy

    F. Pata

  11. Department of Surgery, Ospedale Vannini, Rome, Italy

    S. Tierno

  12. Department of Surgery, Ospedale Grassi, Rome, Italy

    F. Tomassini

Authors
  1. M. Manigrasso
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  2. A. D’Amore
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  21. G. D. De Palma
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Contributions

Study conception and design: MM; data acquisition: EB, LMB, SB, FC, AC, FF, GG, MLT, CM, EM, AM, MM, LM, FP, MP, ST, FT, PV; data analysis and interpretation: ADA, GDDP; drafting the article: MM, ADA; critical revision for intellectual content: EB, LMB, SB, FC, AC, FF, GG, MLT, CM, EM, AM, MM, LM, FP, MP, ST, FT, PV, MM, GDDP; final approval of the manuscript: all authors.

Corresponding author

Correspondence to M. Manigrasso.

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The authors declare that they have no conflict of interest. All authors have no financial conflicts of interest to disclose.

Ethical standards

The study was performed according to the Declaration of Helsinki.

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All included patients signed a written informed consent to be included in the study.

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Manigrasso, M., D’Amore, A., Benatti, E. et al. Five-year recurrence after endoscopic approach to pilonidal sinus disease: A multicentre experience. Tech Coloproctol 27, 929–935 (2023). https://doi.org/10.1007/s10151-023-02846-7

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  • DOI: https://doi.org/10.1007/s10151-023-02846-7

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