BACKGROUND: In the new era of minimally invasive surgery, recent studies encouraged the adoption of endoscopic approaches as the most effective way to treat (pilonidal sinus disease) PSD but little is known about long-term results of minimally invasive procedures. MATERIALS AND METHODS: A total of 145 patients with chronic non recurrent pilonidal sinus were enrolled for this randomized controlled trial. The follow-up rate was 97% at 5 years for a total of 74 patients assigned to the minimally invasive treatment group and 67 patients assigned to the conventional Bascom cleft lift treatment group. We evaluated the following outcomes: long-term recurrence rate, patients' satisfaction, cosmetic outcome and cost-effectiveness results. RESULTS: Long-term data confirm that the recurrence rate was similar in both groups and, in minimally invasive patients, there were a higher satisfaction and better cosmetic results. Costs analysis revealed improved outcome in favour of VAAPS with a much lower mean global cost. CONCLUSION: Minimally invasive treatment has all the characteristics of an ideal approach to PSD with advantages including minimal patient inconveniences, high satisfaction and good aesthetics results. It was also more cost effective to carry out the treatment.
RCT Entities:
BACKGROUND: In the new era of minimally invasive surgery, recent studies encouraged the adoption of endoscopic approaches as the most effective way to treat (pilonidal sinus disease) PSD but little is known about long-term results of minimally invasive procedures. MATERIALS AND METHODS: A total of 145 patients with chronic non recurrent pilonidal sinus were enrolled for this randomized controlled trial. The follow-up rate was 97% at 5 years for a total of 74 patients assigned to the minimally invasive treatment group and 67 patients assigned to the conventional Bascom cleft lift treatment group. We evaluated the following outcomes: long-term recurrence rate, patients' satisfaction, cosmetic outcome and cost-effectiveness results. RESULTS: Long-term data confirm that the recurrence rate was similar in both groups and, in minimally invasive patients, there were a higher satisfaction and better cosmetic results. Costs analysis revealed improved outcome in favour of VAAPS with a much lower mean global cost. CONCLUSION: Minimally invasive treatment has all the characteristics of an ideal approach to PSD with advantages including minimal patient inconveniences, high satisfaction and good aesthetics results. It was also more cost effective to carry out the treatment.
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: Mackenzie N Abraham; Steven L Raymond; Russell B Hawkins; Atif Iqbal; Shawn D Larson; Moiz M Mustafa; Janice A Taylor; Saleem Islam Journal: Front Surg Date: 2021-02-25
Authors: Sara Vertaldi; Pietro Anoldo; Grazia Cantore; Alessia Chini; Anna D'Amore; Maria D'Armiento; Nicola Gennarelli; Francesco Maione; Michele Manigrasso; Alessandra Marello; Pietro Schettino; Carmen Sorrentino; Loredana M Sosa Fernandez; Giovanni D De Palma; Marco Milone Journal: Front Surg Date: 2022-03-03
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