[Sacrococcygeal cysts. Is Lord Millar's procedure an alternative to exeresis?]

The benignancy of sacrococcygeal cysts stands in contrast to their morbidity and rate of recurrence. Due to the differences in the results found in the literature and to the lack of recommendations as to the optimal surgical procedure, the authors have reviewed a series of 69 patients with a chronic inflammatory state. The procedure was either exeresis up to the sacrum (37 patients) or Lord Millar's procedure (32 patients). The latter consisted in a limited exeresis of the portals and in the extraction of the hairs with a brush, followed in principle by a weekly depilatory treatment until the wound was closed. The results in the 2 groups have been compared. Sixty-six patients (87%) were controlled after an average of 3.7 years. The shorter stay in hospital of the patients operated with Lord Millar's procedure (4.9 vs. 7.6 days) and the shorter period of inability to work (14 vs. 26 days) demonstrate the socioeconomical advantage of this procedure. Recurrence occurred in 5 of the 31 patients controlled after exeresis (16%) and in 7 of the 29 patients controlled after a Lord Millar's operation (24%), including one in the subgroup of 16 patients who submitted themselves to a regular postoperative epilatory treatment (6%) and 6 in the group of 13 who were not followed up in our clinic (46%). Thus Lord Millar's procedure represents an alternative to exeresis, provided the patient is motivated enough to submit himself to regular postoperative controls.