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Pediatric pilonidal sinus disease: Recurrence rates of different age groups compared to adults
Dietrich Doll1, Susanne Haas2,3, Ida Kaad Faurschou2,3,4
1Klinik für Proktochirurgie und Pilonidalsinus, St. Marienhospital, Vechta, Germany.
Insights
Pediatric pilonidal sinus disease recurs significantly more often in children than adults, with nearly half of recurrences happening within five years. Further research is needed to understand surgical approaches for better pediatric care.
Area of Science:
- Pediatric Surgery
- Dermatology
- Surgical Outcomes
Background:
- Pilonidal sinus disease is uncommon in pre-pubertal children.
- Optimal treatment for pediatric pilonidal sinus remains unclear.
- Pediatric pilonidal sinus disease has a higher recurrence rate than in adults.
Purpose of the Study:
- To investigate recurrence rates in pediatric pilonidal sinus disease.
- To compare recurrence rates between pediatric and adult patients.
- To analyze recurrence rates across different surgical approaches.
Main Methods:
- Systematic review of 1217 studies.
- Inclusion of 134,663 patients, with 5807 pediatric patients identified.
- Comparison of recurrence rates between adult and pediatric cohorts.
Main Results:
- Pediatric patients exhibit a higher 5-year recurrence rate (46%) compared to adults (11.5%).
- Adolescents aged 16-18 years experience earlier recurrences than younger children.
- 46.4% of pediatric recurrences occur within the first five years post-surgery.
Conclusions:
- Pediatric pilonidal sinus disease has a distinct, more aggressive recurrence pattern than in adults.
- A substantially higher probability of recurrence exists within five years for pediatric patients.
- Limited evidence necessitates further research into surgical approaches to improve pediatric care.
Background:
Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.
Methods:
Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.
Results:
Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %; p < 0.0001). The subgroup of individuals aged 16-18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.
Conclusions:
Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.
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