Document Detail


Minimal surgery for pilonidal disease using trephines: description of a new technique and long-term outcomes in 1,358 patients.
MedLine Citation:
PMID:  18516645     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study describes and reports the results of a new, minimally-invasive surgical technique for pilonidal disease. METHODS: From March 1993 to January 2003, 1,358 patients (out of a total of 1,435 patients) with symptomatic pilonidal disease underwent treatment in a military surgical clinic dedicated for pilonidal disease. Patients were operated on under local anesthesia, utilizing trephines to excise pilonidal pits and to débride underlying cavities and tracts. RESULTS: One thousand three hundred fifty-eight symptomatic patients participated in the study and were mostly male (84.3 percent) and the mean age 20.9 +/- 3.6 years. Rates of postoperative infection, secondary bleeding, and early failure were 1.5, 0.2, and 4.4 percent, respectively. In patients with full postoperative clinical attendance, complete healing was observed within 3.4 +/- 1.9 weeks. Phone interview included 1,165 patients (85.8 percent) with a mean follow-up interval of 6.9 +/- 1.8 years. Recurrence rates after 1 year was 6.5 percent, 5 years was 13.2 percent, and 10 years was 16.2 percent. Mean time to recurrence was 2.7 +/- 2.6 years postoperatively. The disease-free probability estimate was 93.5 percent at one year and 86.5 percent at 5 years. CONCLUSIONS: Compared with frequently used pilonidal operations, the trephine technique is associated with a lower recurrence rate and a low postoperative morbidity rate.
Authors:
Moshe Gips; Yedidia Melki; Leon Salem; Ruben Weil; Jaqueline Sulkes
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Publication Detail:
Type:  Journal Article     Date:  2008-05-31
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  51     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-27     Completed Date:  2008-11-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1656-62; discussion 1662-3     Citation Subset:  IM    
Affiliation:
Pilonidal Sinus Clinic, Surgical Unit, Military Medical Facility, Zerifin, Israel. gipsm@post.tau.ac.il
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Ambulatory Surgical Procedures / instrumentation*
Debridement / instrumentation*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pilonidal Sinus / pathology,  surgery*
Recurrence
Surgical Procedures, Minimally Invasive / instrumentation
Treatment Outcome
Trephining / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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