Related Experiment Video
Updated: May 29, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Sinusectomy for primary pilonidal sinus: less is more
Christopher Soll1, Daniel Dindo, Daniel Steinemann
1Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland.
Background:
Wide excision with secondary wound healing is a frequently performed surgical procedure for pilonidal sinus. This intervention requires general anesthesia and has a wound healing time of up to several months with a long time to return to work. Sinusectomy of the track is an alternative operation. We here describe the long-term outcome of 257 patients operated between 2001 and 2010.
Methods:
Sinusectomy consisted of a selective minimal invasive excision of the sinus after marking the track with methylene blue. Data were collected retrospectively with questionnaires and telephone survey. The main endpoints of the study were recurrence and time off work.
Results:
With a median follow-up of 3.6 years, the overall recurrence rate was 7%. The median time to return to work was 7 days. The proportion of sinusectomies performed under local anesthesia increased from 59% to 93%. Consistently, the proportion of patients treated in 1-day surgery setting increased from 53% to 93%. One-day surgery had a clear impact on time to return to work in uni- and multivariate analyses (HR 1.959 {1.224, 3.137}, P = .005).
Conclusion:
Sinusectomy for pilonidal sinus can be performed with a low recurrence rate. An outpatient setting, including operations under local anesthesia, allows a fast return to normal activity. Sinusectomy should become the first choice for primary non-infected symptomatic pilonidal sinus.
Insights
Sinusectomy offers a low recurrence rate for pilonidal sinus treatment. This minimally invasive procedure allows patients a rapid return to work, often within days.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Pilonidal sinus is commonly treated with wide excision and secondary healing, requiring general anesthesia and prolonged recovery.
- This traditional method leads to extended wound healing times (months) and significant time off work.
Purpose of the Study:
- To evaluate the long-term outcomes of sinusectomy for pilonidal sinus.
- To compare sinusectomy with traditional wide excision regarding recurrence and return to work.
Main Methods:
- A retrospective study of 257 patients undergoing sinusectomy between 2001 and 2010.
- Sinusectomy involved minimal invasive excision of the sinus track after methylene blue marking.
- Data collected via questionnaires and telephone surveys, focusing on recurrence and time off work.
Main Results:
- Median follow-up was 3.6 years with an overall recurrence rate of 7%.
- Median time to return to work was only 7 days.
- Proportion of procedures under local anesthesia increased from 59% to 93%, and 1-day surgery increased from 53% to 93%.
Conclusions:
- Sinusectomy demonstrates a low recurrence rate for pilonidal sinus.
- Outpatient sinusectomy, especially under local anesthesia, facilitates a quick return to normal activities.
- Sinusectomy is recommended as a primary treatment for non-infected symptomatic pilonidal sinus.
