The Minimally Invasive Pilonidal Protocol: Low Short-Term Recurrence after Completion in a Single-Center...

Area of Science:

• Surgery
• Dermatology
• Gastroenterology

Background:

• Pilonidal disease treatment remains challenging with high recurrence rates (up to 30%) after traditional resection or sinusectomy.
• The Pilonidal Care Clinic (PCC) developed the Minimally Invasive Pilonidal Protocol (MIPP) to address these limitations.

Purpose of the Study:

• To evaluate the recurrence rate of pilonidal disease in patients who successfully completed the MIPP.
• To assess the long-term outcomes and effectiveness of the MIPP for pilonidal disease management.

Main Methods:

• A retrospective review of prospectively collected data from patients who completed the MIPP between January 2021 and December 2024.
• Follow-up occurred every 6-8 weeks until disease resolution and laser ablation completion; recurrence was defined as disease presence upon examination after graduation.
• Graduated patients were contacted via text message to assess post-graduation symptoms; patients lost to follow-up or still in treatment were excluded.

Main Results:

• Out of 884 initial patients, 297 completed the MIPP and graduated. The average treatment duration was 12.3 months.
• A recurrence rate of 4.0% (12 out of 297 graduates) was observed, with recurrences occurring an average of 16.3 months post-graduation.
• Of the 12 recurrent cases, 8 had new pits and 4 had both pits and a nidus; 9 of these patients were successfully re-graduated.
• A text survey of 280 non-returning graduates revealed 5.6% reported recurrence, with 94.4% remaining disease-free.

Conclusions:

• Completion of the MIPP is associated with a low recurrence rate of 4.0% for pilonidal disease.
• The majority of recurrences were mild and amenable to further minimally invasive treatment, suggesting MIPP's effectiveness.
• The MIPP offers a promising approach for managing pilonidal disease with favorable long-term outcomes.