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Conservative vs Surgical Interventions for Umbilical Pilonidal Sinus: A Multicenter, Double-Blind, Prospective,
Mehmet Kaplan1, Onder Ozcan2, Fatma Cigdem Kaplan3
1Department of General Surgery, Bahcesehir University (BAU) School of Medicine, Istanbul, Turkey.
Journal of the American College of Surgeons
|March 28, 2016
Summary
Surgical treatment for umbilical pilonidal sinus (UPS) is more effective than conservative methods, leading to faster healing and higher cure rates with significantly less recurrence. This study demonstrates surgical intervention as the superior approach for UPS management.
Area of Science:
- Medical Research
- Surgical Innovation
- Clinical Trials
Background:
- Umbilical pilonidal sinus (UPS) is a neglected disorder with no clear treatment consensus.
- This study addresses the need for evidence-based treatment guidelines for UPS.
Purpose of the Study:
- To compare the efficacy of conservative treatment versus surgical treatment for UPS.
- To evaluate outcomes including initial healing, recurrence rates, and overall cure rates.
Main Methods:
- A prospective, randomized, controlled clinical trial involving 84 UPS patients.
- Patients were randomized into conservative treatment (CT) or surgical treatment (ST) groups (n=42 each).
- Outcomes were assessed over a minimum 2-year follow-up period.
Main Results:
- Surgical treatment (ST) showed significantly shorter initial healing times (p=0.001).
- Recurrence rates were substantially lower in the ST group (1 patient) compared to the CT group (10 patients, p=0.002).
- The cure rate after 2 years was 100% for ST versus 68.3% for CT (p=0.0001).
Conclusions:
- Surgical treatment is superior to conservative treatment for UPS.
- Surgery offers better primary and secondary outcomes, including higher cure rates and lower recurrence.
- The findings support surgical intervention as the preferred management for umbilical pilonidal sinus.
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