Risk of re-operation after Bascom I for pilonidal sinus disease. A Danish population-based cohort study

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Pilonidal Sinus Disease Management

Background:

• Chronic pilonidal sinus disease (PSD) treatment remains controversial.
• Minimally invasive approaches are suitable for minor PSD.
• The Bascom I procedure is the preferred minimally invasive treatment in Denmark.

Purpose of the Study:

• To evaluate re-operation rates after elective Bascom I procedure.
• To identify potential risk factors associated with re-operation.

Main Methods:

• Nationwide Danish database analysis (2010-2021) of patients undergoing Bascom I for PSD.
• Patients categorized based on prior PSD treatments: none, one/two I&D, or other procedures.
• 1-, 2-, and 5-year re-operation risks analyzed, stratified by sex.
• Risk of re-operation after a second Bascom I procedure was assessed.

Main Results:

• 3555 patients underwent Bascom I; 79% were male.
• Overall 5-year re-operation risk was 30%, highest in younger patients.
• 65% of re-operations occurred within the first year.
• The 5-year re-operation risk after a second Bascom I was 45%.

Conclusions:

• High early failure rates contribute to significant re-operation risks following Bascom I.
• Improvements in patient selection, surgical technique, and training are recommended.
• Optimizing Bascom I outcomes requires addressing current procedural shortcomings.