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Updates Surg. 2019 Mar 18. doi: 10.1007/s13304-019-00644-1. [Epub ahead of print]

D-shape asymmetric excision in recurrent pilonidalis disease: an analytic longitudinal long-term evaluation.

Author information

1
Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy. luigi.brusciano@unicampania.it.
2
Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy.
3
Colorectal and Pelvic Floor Diseases Center, Department of General Surgery, "S. Maria dei Battuti" Hospital, Via Brigata Bisagno 4, 31015, Conegliano, TV, Italy.

Abstract

Sacrococcigeal pilonidalis disease (SPD) recurrence is a major factor influencing surgical outcomes. Several different surgical treatments have been reported, however, there is a lack of long-term data on reoperation. Aim of this study was to analyze outcomes of a single center adopting a standardized off-midline asymmetric procedure (D-shape). Analytic longitudinal assessment of 83 patients (median age 35 years, range 23-59 years) with recurrent SPD that completed the 5-year study design following D-shape reoperation. Among a cohort of 607 patients, we enrolled 83 recurrent SPD. After D-shape reoperation, second recurrence rate was 9.6% (8/83). Second recurrence rate was not statistically significantly different among patients undergone D-shape as first surgery compared to patients of symmetric excision group (11.8% vs. 7.4%, p = 0.57). Similarly, there was no statistical difference among patients who underwent D-shape as first surgery compared to patients who underwent symmetric excision elsewhere (11.8% vs. 9.1%, p = .75). D-shape is a safe and effective when adopted as revisional surgery at a long-term follow-up. Comparative evaluation is warranted to establish the potential superiority over different surgical surgery in case of recurrence.

KEYWORDS:

Asymmetric excision; D-shape; Excision; Pilonidal sinus disease; Recurrent sinus; Sinus pilonidalis

PMID:
30887467
DOI:
10.1007/s13304-019-00644-1

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