Sameh Hany Emile1,2, Hossam Elfeki3,4, Mostafa Shalaby3,5, Ahmad Sakr3, Valentina Giaccaglia6, Pierpaolo Sileri5, Steven D Wexner7. 1. Colorectal Surgery Unit, Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. sameh200@hotmail.com. 2. General Surgery Department, Faculty of Medicine, Mansoura University Hospitals, Elgomhuoria Street, Mansoura, Egypt. sameh200@hotmail.com. 3. Colorectal Surgery Unit, Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. 4. Department of Surgery, Aarhus University Hospital, Aarhus, Denmark. 5. Department of General Surgery UOC C, University of Rome Tor Vergata, Rome, Italy. 6. Colorectal Surgery Unit, General Surgery Department, Mediclinic City Hospital, Dubai, United Arab Emirates. 7. Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Abstract
BACKGROUND: Sacrococcygeal pilonidal disease (SPD) is a common surgical condition for which a multitude of surgical treatments have been described. The present review aimed to evaluate the efficacy and safety of a novel endoscopic procedure for the treatment of SPD. METHODS: An organized literature search was conducted. Electronic databases including PubMed/Medline, Scopus, Embase, and Cochrane library were searched for articles that assessed the endoscopic treatment for SPD. The main outcome parameters were failure of the technique including persistence and recurrence of SPD, postoperative complications and pain, time to complete healing, and time to return to work. RESULTS: Nine studies with a total of 497 patients were included. Mean age of patients was 24.8 years. Mean operation time was 34.7 min. The procedure was performed as day-case surgery in all studies. The mean Visual analogue score of pain within the first week was 1.35. Failure of the technique was recorded in 40 (8.04%) patients, 20 (4.02%) had persistent SPD and 20 (4.02%) developed recurrence. The weighted mean failure rate of the technique was 6.3% (95% CI 3.6-9.1). Mean weighted complication rate was 1.1% (95% CI 0.3-2.4). Mean time to complete healing was 32.9 days and mean time to return to work was 2.9 days. CONCLUSION: The endoscopic treatment of pilonidal sinus is a promising and safe method of treatment of SPD. The main advantages of the endoscopic treatment as compared to conventional surgery are the minimal postoperative pain, quick healing, and short time to return to work and daily activities.
BACKGROUND:Sacrococcygeal pilonidal disease (SPD) is a common surgical condition for which a multitude of surgical treatments have been described. The present review aimed to evaluate the efficacy and safety of a novel endoscopic procedure for the treatment of SPD. METHODS: An organized literature search was conducted. Electronic databases including PubMed/Medline, Scopus, Embase, and Cochrane library were searched for articles that assessed the endoscopic treatment for SPD. The main outcome parameters were failure of the technique including persistence and recurrence of SPD, postoperative complications and pain, time to complete healing, and time to return to work. RESULTS: Nine studies with a total of 497 patients were included. Mean age of patients was 24.8 years. Mean operation time was 34.7 min. The procedure was performed as day-case surgery in all studies. The mean Visual analogue score of pain within the first week was 1.35. Failure of the technique was recorded in 40 (8.04%) patients, 20 (4.02%) had persistent SPD and 20 (4.02%) developed recurrence. The weighted mean failure rate of the technique was 6.3% (95% CI 3.6-9.1). Mean weighted complication rate was 1.1% (95% CI 0.3-2.4). Mean time to complete healing was 32.9 days and mean time to return to work was 2.9 days. CONCLUSION: The endoscopic treatment of pilonidal sinus is a promising and safe method of treatment of SPD. The main advantages of the endoscopic treatment as compared to conventional surgery are the minimal postoperative pain, quick healing, and short time to return to work and daily activities.
Authors: Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher Journal: BMJ Date: 2009-07-21
Authors: Marco Milone; Nunzio Velotti; Michele Manigrasso; Francesco Milone; Loredana Maria Sosa Fernandez; Giovanni Domenico De Palma Journal: Updates Surg Date: 2018-12-12
Authors: Michele Manigrasso; Nunzio Velotti; Loredana M Sosa Fernandez; Sara Vertaldi; Francesco Maione; Nicola Gennarelli; Pietro Schettino; Mario Musella; Giovanni D De Palma; Marco Milone Journal: Int J Colorectal Dis Date: 2020-10-03 Impact factor: 2.796
Authors: Michele Manigrasso; Pietro Anoldo; Grazia Cantore; Alessia Chini; Anna D'Amore; Nicola Gennarelli; Francesco Maione; Alessandra Marello; Pietro Schettino; Carmen Sorrentino; Sara Vertaldi; Loredana Maria Sosa Fernandez; Giovanni Domenico De Palma; Marco Milone Journal: Front Surg Date: 2022-01-04