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Trephine Minimally Invasive Procedure for Pilonidal Sinus.

Itay Zoarets1,2, Yehonatan Nevo1,2, Chaya Schwartz1,2

  • 1Department of Surgery and Transplantation, Sheba Medical Center, Tel Hashomer.

The Israel Medical Association Journal : IMAJ
|February 21, 2022
PubMed
Summary

The trephine procedure for pilonidal sinus shows short-term benefits like quick recovery and low pain. However, it has a high long-term recurrence rate, with factors like obesity and smoking increasing risk.

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Area of Science:

  • Surgical outcomes and patient recovery in proctology and general surgery.

Background:

  • Pilonidal sinus is a chronic inflammatory condition with debated surgical management strategies.
  • The trephine technique is one surgical option for treating pilonidal sinus.

Purpose of the Study:

  • To evaluate the short- and long-term outcomes of the trephine procedure for pilonidal sinus treatment.
  • To determine the success rate and recurrence patterns associated with the trephine technique.

Main Methods:

  • A retrospective observational cohort study included 169 patients treated between 2011 and 2015.
  • Data were collected via medical records review and telephone interviews for long-term follow-up.

Main Results:

  • A 45.1% recurrence rate was observed at a median follow-up of 29 months, with 33.9% requiring further surgery.
  • Short-term outcomes included low morbidity, rapid recovery (median 10 days to return to work/school), and minimal quality of life impairment.
  • Overweight, smoking, and family history were linked to increased recurrence risk.

Conclusions:

  • The trephine technique for pilonidal sinus is associated with a significant long-term recurrence rate.
  • Despite high recurrence, it offers short-term advantages such as low morbidity and enhanced recovery.
  • The trephine procedure may be considered as an initial treatment option for pilonidal disease.