D-shape asymmetric excision in recurrent pilonidalis disease: an analytic longitudinal long-term evaluation

Area of Science:

• Colorectal Surgery
• Surgical Outcomes Research
• Pilonidal Disease Management

Background:

• Recurrence of sacrococcgeal pilonidalis disease (SPD) significantly impacts surgical outcomes.
• Long-term data on reoperation for recurrent SPD is limited.
• Standardized surgical approaches are needed to improve patient management.

Purpose of the Study:

• To analyze the long-term outcomes of a standardized off-midline asymmetric (D-shape) procedure for recurrent SPD.
• To evaluate the safety and efficacy of the D-shape procedure as a revisional surgery.
• To compare recurrence rates following D-shape reoperation with previous surgical methods.

Main Methods:

• Longitudinal assessment of 83 patients with recurrent SPD undergoing D-shape reoperation over a 5-year period.
• Analysis of second recurrence rates after D-shape reoperation.
• Comparison of recurrence rates between patients who had D-shape as primary or revisional surgery and those who underwent symmetric excision.

Main Results:

• The second recurrence rate after D-shape reoperation was 9.6% (8/83 patients).
• No statistically significant difference in recurrence rates was observed when comparing D-shape as a first surgery versus symmetric excision (11.8% vs 7.4%).
• No significant difference in recurrence rates was found when comparing D-shape as a first surgery versus prior symmetric excision elsewhere (11.8% vs 9.1%).

Conclusions:

• The D-shape procedure is a safe and effective option for revisional surgery in patients with recurrent sacrococcgeal pilonidalis disease.
• Long-term follow-up supports the use of the D-shape technique in managing recurrent SPD.
• Further comparative studies are warranted to determine the superiority of the D-shape procedure over other surgical techniques for recurrent cases.