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Timeline of Recurrence After Primary and Secondary Pilonidal Sinus Surgery

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Diseases of the Colon & Rectum

Abstract

Purpose

This study was designed to evaluate the timeline of recurrence of pilonidal sinus disease after primary vs. multiple surgery. Data of medical military service in Germany were reviewed.

Methods

Telephone interview of 205 patients after pilonidal sinus disease surgery after median interval of 14.8 (standard deviation ±3.9) years was conducted. A total of 345 patient charts with pilonidal sinus disease recurrence and fully documented previous surgery history were analyzed.

Results

Pilonidal sinus disease recurred in 41 of 205 patients (20 percent; actuarial survival 22 percent) after first surgery. Median recurrence-free-interval was 1.8 (range, 0.1-6.5) years. Twenty-nine of 41 of all recurrences (71 percent) were observed within four years after primary surgery. Fifteen of 50 patients (30 percent) treated by primary closure had recurrent disease after a median recurrence-free interval of 2.7 (range, 0.2-3.5) years compared with 24 of 144 patients (17 percent), who experienced recurrence after rhomboid excision and open wound treatment after a median of 1.8 (range 0.1-6.5) years (P--.081, long-rank-test). Analysis of 345 recurrent disease charts revealed that recurrence time decreased for multiple recurrences compared with first recurrence (R1 vs. R2: P--.07; R2 vs. R3: P--.03, Mann-Whitney U test).

Conclusions

Long-term recurrence rate was 22 percent and thus higher than previously reported. This may be attributed to the long follow-up interval. Recurrences up to 20 years after surgery were seen. Our data provide evidence that follow-up after first to the third pilonidal sinus surgery should complete or exceed five years, because the majority of recurrences occur during this postoperative interval. Nevertheless, even a five-year follow-up will still miss 25 percent of recurrences.

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Acknowledgment

The authors thank Mrs. Anne Boulesteix for invaluable statistical advise, and Mr. Luedde and Mr. Eisele from the Institute for Military Medical Statistics in Remagen for tracing medical records sometimes older than patient’s age at operation.

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Authors and Affiliations

  1. Department of Surgery, Bundeswehrkrankenhaus Berlin, Berlin, Germany

    Dietrich Doll M.D., Stefan Schrank M.D., Heidi Dettmann M.D. & Wolfgang Duesel M.D.

  2. Department of Surgery, Klinikum Neuköln, Berlin, Germany

    Colin M. Krueger M.D.

  3. Department of Surgery, Bethesda General Hospital gGmbH Hamburg-Bergedorf, Hamburg, Germany

    Sven Petersen M.D., Ph.D.

Authors
  1. Dietrich Doll M.D.
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  2. Colin M. Krueger M.D.
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  3. Stefan Schrank M.D.
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  4. Heidi Dettmann M.D.
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  5. Sven Petersen M.D., Ph.D.
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  6. Wolfgang Duesel M.D.
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Correspondence to Dietrich Doll M.D..

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Doll, D., Krueger, C.M., Schrank, S. et al. Timeline of Recurrence After Primary and Secondary Pilonidal Sinus Surgery. Dis Colon Rectum 50, 1928–1934 (2007). https://doi.org/10.1007/s10350-007-9031-4

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  • DOI: https://doi.org/10.1007/s10350-007-9031-4

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