SP10.11 Does Specialised training reduce the recurrence rate of pilonidal sinus disease surgery?
Mohamed Issa, Maria Kausar, Victor Adeyera, Archana Easwaran, Anthony Kawesha- Surgery
Abstract
Background
Pilonidal sinus surgery is challenging, and its recurrence rates have been reported to be high as 30% in a number of series. Long-term morbidity, recurrent infection, non-healing, and chronic wound discharge affect patients’ quality of life. This study aimed to compare the recurrence rate of the different surgical techniques of pilonidal sinus disease in our institution.
Methods
A retrospective study was done of adults who had elective pilonidal surgery from 2016-2021. Recurrence was defined as an active disease that required surgical intervention >30 days after surgery. Results were analysed for the different operative techniques used.
Results
208 patients were included,167 (80.3%) were male with a mean age of 31.2 years. The mean follow-up was 47 months. The recurrence was reported in 19 cases (9%). Out of 17 cases done by excision and lay-open technique, 11.8% had a recurrence, while 9.8% of 143 recured after simple excision and closure. Only 3 of 48 cases with the flap technique had a recurrence. When the surgeon specialty was analysed as a factor of recurrence, colorectal surgeons did 38% (19/208) of the cases including flap technique, and their recurrence rate was 6.3% (5/79). In comparison, non-colorectal general surgeons operated on 50.5% (105/208) of the cases with no flap technique, and their recurrence rate was 11.4% (12/105). Only 2 out of 24 cases were operated by plastic surgeons had a recurrence.
Conclusions
Flap reconstruction yields a low recurrence rate in pilonidal sinus disease surgery. Specialised training for this procedure should be encouraged for the colorectal trainees, that may improve the outcome.