Five-year recurrence after endoscopic approach to pilonidal sinus disease: A multicentre experience

Area of Science:

• Surgical innovation
• Minimally invasive surgery
• Proctology

Background:

• Pilonidal sinus disease (PSD) affects a significant number of patients, often requiring surgical intervention.
• Recurrence after treatment remains a challenge, impacting patient quality of life and healthcare costs.
• Endoscopic sinusectomy offers a minimally invasive approach to PSD treatment.

Purpose of the Study:

• To evaluate the 5-year recurrence rate of pilonidal sinus disease (PSD) following endoscopic sinusectomy.
• To identify specific patient and disease characteristics that serve as independent risk factors for recurrence.

Main Methods:

• Retrospective analysis of a prospectively maintained database of 290 patients undergoing endoscopic sinusectomy across seven centers (September 2011 - December 2017).
• Evaluation of 5-year follow-up data to determine recurrence rates.
• Statistical analysis, including multivariate analysis and ROC curve analysis, to identify risk factors.

Main Results:

• The overall 5-year recurrence rate for pilonidal sinus disease (PSD) after endoscopic sinusectomy was 25.2% (73 out of 290 patients).
• Independent risk factors for recurrence included the presence of sinus pits off the midline and a greater distance of the most lateral orifice from the midline.
• A distance of the most lateral orifice >2 cm from the midline predicted a 63.2% recurrence rate, compared to 6.7% for distances <2 cm.

Conclusions:

• The location of sinus pits off the midline and the distance of the lateral orifice from the midline are significant predictors of recurrence after endoscopic sinusectomy for PSD.
• These findings can help clinicians select appropriate candidates for endoscopic treatment and manage patient expectations regarding recurrence risk.