Outcomes from the surgical management of pilonidal sinus disease: a retrospective cohort study and literature review
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Background: Pilonidal Sinus Disease is a challenging ailment that often requires surgical intervention for effective management. While the Karydakis is a well-tested approach to pilonidal sinus disease, the minimal tissue excision method has early evidence as a promising alternative in the treatment of pilonidal sinus disease. Our study aims to compare the minimal tissue excision method to the Karydakis procedure focusing on parameters such as final healing, initial healing, recurrence, time to healing, the number of subsequent operations, and time to recurrence. Methods: A total of 152 patients were included in this retrospective analysis, with 45 patients undergoing the minimal tissue excision procedure and 107 patients undergoing the Karydakis procedure for Pilonidal Sinus Disease. Data regarding the specified parameters were collected and statistically analyzed to assess the differences between the two surgical approaches. Results: Our analysis revealed no statistically significant differences between the minimal tissue excision and Karydakis techniques in terms of final healing (p = 0.779), initial healing (p = 0.436), recurrence post-healing (p = 0.242), the number of subsequent operations (p = 0.287), and time to recurrence (p = 1). However, a significant difference was observed in the time to healing, with the Karydakis method demonstrating a shorter median healing time (14.50 days) compared to the minimal tissue excision approach (68.00 days, p < 0.001). Conclusions: This comparative analysis suggests that both the minimal tissue excision and Karydakis surgical techniques yield comparable outcomes in the treatment of Pilonidal Sinus Disease concerning final healing, initial healing, recurrence, the number of subsequent operations, and time to recurrence. However, the Karydakis method stands out as it significantly shortens the time to healing, potentially offering a quicker recovery for patients.
