Michele Manigrasso1, Nunzio Velotti2, Loredana M Sosa Fernandez2,3, Sara Vertaldi2, Francesco Maione4, Nicola Gennarelli4, Pietro Schettino4, Mario Musella2, Giovanni D De Palma4, Marco Milone4. 1. Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. michele.manigrasso@unina.it. 2. Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. 3. EMBRYOS Fertility Center and Day Surgery, Palazzo Colosseum, Via Fiorignano, 84091, Battipaglia, Salerno, Italy. 4. Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.
Abstract
BACKGROUND: According to the Italian Society of Colorectal Surgery guidelines, the most effective approach to the pilonidal abscess is adequate surgical drainage, concerning incision and drainage of the pilonidal cavity. Few recent studies have demonstrated that endoscopic approach could be a valid treatment option even in the case of acute pilonidal abscess. The aim of our study is to assess if video-assisted ablation of pilonidal sinus (VAAPS) could be an alternative to treat an acute pilonidal abscess and to evaluate if an immediate endoscopic approach to the pilonidal abscess is preferable to a delayed procedure after incision and drainage. METHODS: All consecutive patients with an acute pilonidal abscess since 1 January 2014 to 31 December 2018 were enrolled in our propensity score-matched analysis and divided into two groups: the early VAAPS group and the delayed VAAPS group. Primary outcomes were recurrence rate at 1-year, 3-year, and 5-year follow-up. Secondary outcomes were time off, time to wound healing, incomplete wound healing, perioperative infection, patients' satisfaction 1 month after the complete wound healing, and their health status before surgery and 6 months after complete wound healing. RESULTS: After the propensity score matching, 82 patients were included in the final analysis (41 in each group). No differences were found in terms of recurrence in the two groups. Early endoscopic approach was associated with a better patients' satisfaction (8.17 ± 1.2 vs 6.06 ± 1.48, p = 0.001) and a better postoperative health status (86.27 ± 6.54 vs 77.32 ± 5.85, p = 0.001). CONCLUSIONS: Our results encouraged to perform an immediate endoscopic approach to an acute pilonidal abscess.
BACKGROUND: According to the Italian Society of Colorectal Surgery guidelines, the most effective approach to the pilonidal abscess is adequate surgical drainage, concerning incision and drainage of the pilonidal cavity. Few recent studies have demonstrated that endoscopic approach could be a valid treatment option even in the case of acute pilonidal abscess. The aim of our study is to assess if video-assisted ablation of pilonidal sinus (VAAPS) could be an alternative to treat an acute pilonidal abscess and to evaluate if an immediate endoscopic approach to the pilonidal abscess is preferable to a delayed procedure after incision and drainage. METHODS: All consecutive patients with an acute pilonidal abscess since 1 January 2014 to 31 December 2018 were enrolled in our propensity score-matched analysis and divided into two groups: the early VAAPS group and the delayed VAAPS group. Primary outcomes were recurrence rate at 1-year, 3-year, and 5-year follow-up. Secondary outcomes were time off, time to wound healing, incomplete wound healing, perioperative infection, patients' satisfaction 1 month after the complete wound healing, and their health status before surgery and 6 months after complete wound healing. RESULTS: After the propensity score matching, 82 patients were included in the final analysis (41 in each group). No differences were found in terms of recurrence in the two groups. Early endoscopic approach was associated with a better patients' satisfaction (8.17 ± 1.2 vs 6.06 ± 1.48, p = 0.001) and a better postoperative health status (86.27 ± 6.54 vs 77.32 ± 5.85, p = 0.001). CONCLUSIONS: Our results encouraged to perform an immediate endoscopic approach to an acute pilonidal abscess.
Authors: Marco Milone; Nunzio Velotti; Michele Manigrasso; Sara Vertaldi; Katia Di Lauro; Giuseppe De Simone; Vera Cirillo; Francesco Maione; Nicola Gennarelli; Loredana Maria Sosa Fernandez; Giovanni Domenico De Palma Journal: Int J Surg Date: 2020-01-09 Impact factor: 6.071
Authors: M Milone; M N D Di Minno; M Musella; P Maietta; P Ambrosino; A Pisapia; G Salvatore; F Milone Journal: Tech Coloproctol Date: 2013-06-11 Impact factor: 3.781
Authors: Marco Milone; Mario Musella; Attilio Di Spiezio Sardo; Giuseppe Bifulco; Giuseppe Salvatore; Loredana Maria Sosa Fernandez; Paolo Bianco; Brunella Zizolfi; Carmine Nappi; Francesco Milone Journal: Surgery Date: 2013-10-25 Impact factor: 3.982
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