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Minimal Surgery for Pilonidal Disease Using Trephines: Description of a New Technique and Long-Term Outcomes in 1,358 Patients

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Diseases of the Colon & Rectum

Abstract

Purpose

This study describes and reports the results of a new, minimally-invasive surgical technique for pilonidal disease.

Methods

From March 1993 to January 2003, 1,358 patients (out of a total of 1,435 patients) with symptomatic pilonidal disease underwent treatment in a military surgical clinic dedicated for pilonidal disease. Patients were operated on under local anesthesia, utilizing trephines to excise pilonidal pits and to débride underlying cavities and tracts.

Results

One thousand three hundred fifty-eight symptomatic patients participated in the study and were mostly male (84.3 percent) and the mean age 20.9 ± 3.6 years. Rates of postoperative infection, secondary bleeding, and early failure were 1.5, 0.2, and 4.4 percent, respectively. In patients with full postoperative clinical attendance, complete healing was observed within 3.4 ± 1.9 weeks. Phone interview included 1,165 patients (85.8 percent) with a mean follow-up interval of 6.9 ± 1.8 years. Recurrence rates after 1 year was 6.5 percent, 5 years was 13.2 percent, and 10 years was 16.2 percent. Mean time to recurrence was 2.7 ± 2.6 years postoperatively. The disease-free probability estimate was 93.5 percent at one year and 86.5 percent at 5 years.

Conclusions

Compared with frequently used pilonidal operations, the trephine technique is associated with a lower recurrence rate and a low postoperative morbidity rate.

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Authors and Affiliations

  1. Pilonidal Sinus Clinic, Surgical Unit, Military Medical Facility, Zerifin, Israel

    Moshe Gips M.D.

  2. Department of Surgery B, and the Sackler School of Medicine, Tel-Aviv University, Golda-Hasharon Campus, Rabin Medical Center, Petach-Tikva, Israel

    Moshe Gips M.D., Yedidia Melki M.D., Leon Salem M.D. & Ruben Weil M.D.

  3. Epidemiology Unit, Beilinson Campus, Rabin Medical Center, Petach-Tikva, Israel

    Jaqueline Sulkes Ph.D.

Authors
  1. Moshe Gips M.D.
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  2. Yedidia Melki M.D.
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  3. Leon Salem M.D.
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  4. Ruben Weil M.D.
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  5. Jaqueline Sulkes Ph.D.
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Corresponding author

Correspondence to Moshe Gips M.D..

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Gips, M., Melki, Y., Salem, L. et al. Minimal Surgery for Pilonidal Disease Using Trephines: Description of a New Technique and Long-Term Outcomes in 1,358 Patients. Dis Colon Rectum 51, 1656–1663 (2008). https://doi.org/10.1007/s10350-008-9329-x

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  • DOI: https://doi.org/10.1007/s10350-008-9329-x

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