M Milone1, N Velotti2, M Manigrasso2, P Anoldo2, F Milone2, G D De Palma2. 1. Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Via S. Pansini, 5, Naples, Italy. Electronic address: marco.milone.md@gmail.com. 2. Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Via S. Pansini, 5, Naples, Italy.
Abstract
BACKGROUND: Sacrococcygeal pilonidal sinus disease (PSD) is a common chronic inflammation of the natal cleft and presents as an abscess or a chronically discharging, painful sinus tract. The management of chronic PSD is variable, contentious, and problematic. Although many surgical procedures have been tried, the best surgical method remains controversial. The aim of this systematic review with meta-analysis of literature is to provide surgeons an objective instrument of decision through an analysis of recurrence rate of various surgical techniques in a long-term follow-up. METHODS: Systematic literature searches were performed to identify all available studies. According to the pre-specified protocol, all studies reporting a surgical approach to PSD with a minimum follow-up of 5 years were included. RESULTS: Fifteen studies were included in the analysis. The number of patients varied from 50 to 1165 with a mean follow-up from 58.36 to 240 months. The overall incidence of recurrence was of 0.138; the resulting incidence of open healing, midline closure and out-midline closure were of 17.9%, 16.8% and 10% respectively. CONCLUSIONS: Interestingly, our data reveal a rate of relapsing disease higher than the one defined in previous studies both for the overall PSD and for each surgical procedure. A long-term follow-up of at least 5 years, should be considered the gold standard in pilonidal sinus surgery benchmarking. From our results, we can state that open healing and midline closure should not be considered effective for their high frequency of relapse disease and midline primary closure should be preferred.
BACKGROUND:Sacrococcygeal pilonidal sinus disease (PSD) is a common chronic inflammation of the natal cleft and presents as an abscess or a chronically discharging, painful sinus tract. The management of chronic PSD is variable, contentious, and problematic. Although many surgical procedures have been tried, the best surgical method remains controversial. The aim of this systematic review with meta-analysis of literature is to provide surgeons an objective instrument of decision through an analysis of recurrence rate of various surgical techniques in a long-term follow-up. METHODS: Systematic literature searches were performed to identify all available studies. According to the pre-specified protocol, all studies reporting a surgical approach to PSD with a minimum follow-up of 5 years were included. RESULTS: Fifteen studies were included in the analysis. The number of patients varied from 50 to 1165 with a mean follow-up from 58.36 to 240 months. The overall incidence of recurrence was of 0.138; the resulting incidence of open healing, midline closure and out-midline closure were of 17.9%, 16.8% and 10% respectively. CONCLUSIONS: Interestingly, our data reveal a rate of relapsing disease higher than the one defined in previous studies both for the overall PSD and for each surgical procedure. A long-term follow-up of at least 5 years, should be considered the gold standard in pilonidal sinus surgery benchmarking. From our results, we can state that open healing and midline closure should not be considered effective for their high frequency of relapse disease and midline primary closure should be preferred.
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: Nunzio Velotti; Michele Manigrasso; Katia Di Lauro; Enrico Araimo; Federica Calculli; Sara Vertaldi; Pietro Anoldo; Giovanni Aprea; Giuseppe De Simone; Antonio Vitiello; Mario Musella; Marco Milone; Giovanni Domenico De Palma; Francesco Milone; Loredana Maria Sosa Fernandez Journal: Open Med (Wars) Date: 2019-08-07
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
Authors: R Perinotti; G Gallo; M Milone; L Basso; M Manigrasso; R Pietroletti; A Bondurri; M La Torre; G Milito; M Pozzo; D Segre Journal: Tech Coloproctol Date: 2021-06-27 Impact factor: 3.781