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coloproctology

, Volume 41, Issue 2, pp 96–100 | Cite as

Recurrence rates after uncommon surgical procedures for pilonidal sinus disease

A merged data analysis
  • T. Baur
  • V. K. Stauffer
  • A. P. Vogt
  • P. Kauf
  • M. Schmid
  • M. M. LuediEmail author
  • D. Doll
Leitthema
  • 20 Downloads

Abstract

Background

Pilonidal sinus disease is a frequent disorder in young men. Recurrence depends greatly on both the surgical procedure selected and the follow-up time. We systematically searched the literature and analyzed available data for recurrence rates after uncommon therapy techniques, specifically endoscopic approaches, the seton technique, and conservative treatment. We then compared recurrence rates with those of well-established techniques and determined the relationship between recurrence and follow-up time for uncommon therapies.

Methods

We analyzed 13 studies published between 1949 and 2017 for uncommon surgical procedures and found one randomized controlled trial (RCT) and 12 non-RCTs including 566 patients. As there was only one RCT, we conducted a merged data analysis including both the RCT and the non-RCTs.

Results

Recurrence rates following endoscopic approaches were 8.5% after 12 months in the merged data and 3.9% after 12 months when considering only the available RCT. The seton technique was associated with a mean recurrence rate of 6.9% at 12 months after initial treatment. Recurrence rates following conservative treatment were 1.0% after 18 months, 4.7% after 24 months, 8.8% after 60 months, and 15.3% after 112 months.

Conclusion

Recurrence rates following uncommon techniques fall within the range of well-established surgical approaches. However, data are sparse, with long-term results missing, and future studies may reveal a more differentiated picture for newer techniques such as endoscopic procedures.

Keywords

Conservative treatment Relapse Follow-up time Kaplan–Meier analysis Surgical procedures, endoscopic 

Rezidivrate nach seltenen chirurgischen Eingriffen bei Pilonidalsinus

Analyse zusammengeführter Daten

Zusammenfassung

Hintergrund

Ein Pilonidalsinus ist eine häufige Erkrankung bei jungen Männern. Die Rezidivrate hängt stark vom gewählten chirurgischen Verfahren und der Nachbeobachtungszeit ab. Die Autoren suchten systematisch nach Literatur und verfügbaren Daten bezüglich der Rezidivraten bei ungewöhnlichen Therapieverfahren und verglichen diese dann mit denen etablierter Techniken.

Methoden

Die Autoren analysierten 13 Studien, die zwischen 1949 und 2017 für seltene chirurgische Eingriffe veröffentlicht wurden (davon eine randomisierte kontrollierte Studie, RCT, und 12 nichtrandomisierte kontrollierte Studien mit insgesamt 566 Patienten).

Ergebnisse

Die Rezidivraten nach endoskopischen Therapien zeigen in den zusammengeführten Daten nach 12 Monaten Rezidivraten von 8,5 bzw. von 3,9 %, wenn nur die eine verfügbare RCT berücksichtigt wurde. Die Seton-Technik zeigte 12 Monate nach der Erstbehandlung eine mittlere Rezidivrate von 6,9 %. Bei konservativer Behandlung betrug die Rezidivrate 1,0 % nach 18 Monaten, 4,7 % nach 24 Monaten, 8,8 % nach 60 Monaten und 15,3 % nach 112 Monaten.

Schlussfolgerung

Rezidivraten bei ungewöhnlichen Techniken entsprechen jenen von etablierten chirurgischen Ansätzen. Die Daten sind jedoch spärlich und Langzeitergebnisse fehlen. Zukünftige Studien könnten ein differenzierteres Bild bezüglich neuerer Techniken wie z. B. endoskopischen Verfahren ergeben.

Schlüsselwörter

Konservative Behandlung Rezidiv Nachbeobachtungsdauer Kaplan-Meier-Analyse Endoskopische Operationen 

Notes

Compliance with ethical guidelines

Conflict of interest

T. Baur, V.K. Stauffer, A.P. Vogt, P. Kauf, M. Schmid, M.M. Luedi, and D. Doll declare that they have no competing interests. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors and their relatives have no relevant or minor financial relationships with external companies.

We did not carry out research with human participants. Therefore, no informed consent was needed prior to preparation of the current manuscript.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • T. Baur
    • 1
  • V. K. Stauffer
    • 2
  • A. P. Vogt
    • 1
  • P. Kauf
    • 3
  • M. Schmid
    • 3
  • M. M. Luedi
    • 1
    Email author
  • D. Doll
    • 4
  1. 1.Department of Anaesthesiology and Pain Medicine, Bern University Hospital, InselspitalUniversity of BernBernSwitzerland
  2. 2.SonnenhofspitalLindenhof Group BernBernSwitzerland
  3. 3.Biomedical Statistics PROGNOSIX AGZurichSwitzerland
  4. 4.Department of Procto-Surgery, St. Marien-Krankenhaus VechtaTeaching Hospital of the Hannover UniversityVechtaGermany

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