Related Experiment Video
Updated: May 29, 2025
Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
Evaluation of Outcomes for Karydakis Operation for Pilonidal Sinus Disease-Comparison of Original Reports With Later
Dietrich Doll1,2, Theo Hackmann1,2, Susanne Haas2,3
1Department of Procto-Surgery & Pilonidal Sinus, St. Marienhospital Vechta, Academic Teaching Hospital of the MHH Hannover, Vechta, Germany.
Background:
Karydakis published his advancement flap technique to treat pilonidal sinus disease (PSD) in 1973 (GEK73) and reported a very low recurrence rate in 1992 (GEK92) in a large series of cases. Since then, the procedure has been widely adapted without replicating his results.
Aim:
To compare the outcomes of the Karydakis 1992 report to the global literature and evaluate reasons for the major discrepancy in recurrence rates.
Methods:
From an international database including all PSD studies, we identified 113 other studies encompassing 9878 patients undergoing the Karydakis advancement flap surgery. Recurrence rates at 5- and 10-year follow-ups were compared to the data presented in the Karydakis 1992 paper.
Results:
The Karydakis 1992 study reports a recurrence rate < 1% with a follow-up ranging between 2 and 20 years. In the global literature, the 10-year recurrence rate is 8.8% in RCTs and 14.6% in nonRCTs which is 11.6- and 19.2-fold higher.
Conclusion:
The standard for recurrence rates after the Karydakis advancement flap set by Karydakis has not since been replicated in the global literature. For surgeons and patients alike it is important to have realistic expectations of short- and long-term outcomes.
