Updates in Surgery

, Volume 71, Issue 1, pp 179–183 | Cite as

Video-assisted ablation of pilonidal sinus (VAAPS) versus sinusectomy for treatment of chronic pilonidal sinus disease: a comparative study

  • Marco MiloneEmail author
  • Nunzio Velotti
  • Michele Manigrasso
  • Francesco Milone
  • Loredana Maria Sosa Fernandez
  • Giovanni Domenico De Palma
Original Article


Since its first description in 1883, different treatments for pilonidal sinus disease have been proposed, but we are still far from the identification of an ideal approach. The objective of this study is to determine if video-assisted ablation of pilonidal sinus (VAAPS) could be considered superior/non-inferior to standard sinusectomy for treatment of pilonidal sinus disease. After applying propensity score analysis, data from 40 patients who underwent sinusectomy and 40 patients who underwent VAAPS, from March 2011 to August 2013, were collected. The two groups were similar in terms of sex, age, BMI, smoking status and complexity of sinus. The mean operative time was less for the sinusectomy group compared with the minimally invasive treatment group (30.38 ± 6.23 vs 44.39 ± 7.76; p = 0.001). On the other hand, the recurrence rate (7.5% vs 25%; p = 0.035) was significantly lower in the VAAPS group and the infection rate showed a trend toward reduction in the endoscopically treated patients (12.5% vs 30%; p = 0.057). No differences were found in terms of pain score at 1 week from surgery (3.71 ± 1.24 vs 3.76 ± 1.39; p = 0.883), satisfaction at 6 months (8.3 ± 1.2 vs 8.2 ± 1.3; p = 0.78) and time off work (2.01 ± 1.30 vs 2.08 ± 1.24; p = 0.620). The effectiveness of our new technique can be assessed again and the comparative analysis with the conventional sinusectomy shows the feasibility of VAAPS, suggesting that this procedure is the best way to perform a sinusectomy.


Pilonidal sinus Sinusectomy VAAPS Minimally invasive surgery 


Author contributions

MM: conception, design, interpretation of the data and drafting of the article; MM, MM, NV, FM, LMSF: acquisition, analysis and interpretation of the data; FM, GDDP: interpretation of the data and critical revisions; GDDP: critical revisions and final approval.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

13304_2018_611_MOESM1_ESM.docx (29 kb)
Supplementary material 1 (docx 29 kb)


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Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  • Marco Milone
    • 1
    Email author
  • Nunzio Velotti
    • 1
  • Michele Manigrasso
    • 1
  • Francesco Milone
    • 1
  • Loredana Maria Sosa Fernandez
    • 2
  • Giovanni Domenico De Palma
    • 1
  1. 1.Department of Clinical Medicine and SurgeryFederico II University of NaplesNaplesItaly
  2. 2.Embryos Fertility CenterSalernoItaly

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