Karydakis procedure can be effectively performed in the lateral position.

Area of Science:

• Surgical Procedures
• Pilonidal Disease Management
• Clinical Outcomes Research

Background:

• The Karydakis procedure (KP) is a surgical technique for pilonidal disease.
• Previous reports indicate low recurrence (<1%) and complication (8.5%) rates for KP.
• This study aimed to compare KP outcomes based on patient positioning.

Purpose of the Study:

• To compare the efficacy and safety of the Karydakis procedure (KP) when performed in the lateral versus the prone position.
• To evaluate differences in complication rates, disease recurrence, operating time, and hospital stay between the two positions.

Main Methods:

• Retrospective analysis of 97 consecutive patients who underwent KP between March 2000 and February 2018.
• Patients with midline sinuses or fistulas extending laterally were considered for contralateral side positioning.
• Data collected included wound complications, disease recurrence, operating time, and length of hospital stay.

Main Results:

• Surgery was performed for primary (73%) and recurrent (27%) pilonidal disease.
• Wound complications occurred in 38% of patients, and disease recurrence in 8%.
• No significant differences were observed between lateral and prone positions regarding wound complications (41% vs. 35%), recurrence (9% vs. 7%), operating time (64.6 vs. 66.6 min), or hospital stay (1 day for both).

Conclusions:

• The Karydakis procedure (KP) can be performed safely and effectively in the lateral position for most pilonidal disease cases.
• Lateral positioning may offer benefits in patient safety, comfort, and operating room efficiency.
• Clinical results support the lateral position as a viable alternative to the prone position for KP.