Romaniszyn M, Swirta JS, Walega PJ. Long-term results of endoscopic pilonidal sinus treatment vs Limberg flap for treatment of difficult cases of complicated pilonidal disease: a prospective, nonrandomized study.
Colorectal Dis 2020;
22:319-324. [PMID:
31532869 DOI:
10.1111/codi.14857]
[Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/12/2019] [Indexed: 12/13/2022]
Abstract
AIM
To present the results of a prospective, nonrandomized comparative study on the treatment of complicated pilonidal sinus by endoscopic pilonidal sinus treatment (EPSiT) compared with Limberg flap surgery, based on experience of a single surgical centre.
METHOD
A prospective, nonrandomized comparative study. Long-term follow-up of 62 patients with complicated pilonidal disease was analysed (36 operated on using the Limberg flap technique and 26 using the EPSiT method). The median follow-up was 27 months (12-44).
RESULTS
The median operating time in the EPSiT group was 60 min (25-80 min) and in the Limberg group 67 min (35-95 min). In the EPSiT group, primary healing was achieved in 22 out of 26 patients (84.6%) in a median of 42 days with a total complication rate of 11.5%. There were seven recurrences after initial healing. The total success rate of the EPSiT procedure with long-term follow-up was 57.7%. In the Limberg flap group, all patients healed (100%) in a median of 21 days. The complication rate in this group was 26.5%, and there were two recurrences in this group. The total success rate of the Limberg flap procedure was 94.1%.
CONCLUSION
For patients with complicated pilonidal sinus, the endoscopic procedure has a significantly lower success rate than the Limberg flap procedure, but a lower risk of complications. Such patients should be offered a choice between a safer, minimally invasive procedure with a higher risk of recurrence or flap surgery, which is more effective, but with a higher risk of complications.
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