A nationwide snapshot study on outcomes one year after surgery for chronic pilonidal sinus disease

Eleonora A Huurman; Christel A L de Raaff; Rosaline van den Berg; Sara J Baart; Bas P L Wijnhoven; Ruben Schouten; Edgar J B Furnée; Robert M Smeenk; Boudewijn R Toorenvliet; PITS collaborative study group

doi:10.1111/codi.17217

A nationwide snapshot study on outcomes one year after surgery for chronic pilonidal sinus disease

Colorectal Dis. 2024 Dec 2. doi: 10.1111/codi.17217. Online ahead of print.

Collaborators

PITS collaborative study group:
A Moekotte, P M H Nierop, W Bleeker, H Bouwman, A van Erp, O van Ruler, M Vermaas, S Ottenhof, H Veger, S Willems, I J M Han-Geurts, L Dekker, J Y van Oostendorp, J Konsten, T Schok, G Vijgen, S Clermonts, H Brokx, J Diks, L van Steensel, I van Koeverden, F H W Jonker, A Emmen, T Lettinga, I Mulder, R Klaassen, K P Jansen, M W G A Bronkhorst, M J Reiniers, R Crolla, M Lagendijk, W Kelder, N Vuurberg, E van den Hoed, N Smakman, J de Kort, M Vissink, H Stockmann, R van der Stappen, N Tjahjadi, J P de Zoete, K Rovers, S Damen, R Hijmans, P Steenvoorde, S van der Burg, J Klinkenbijl, C Lovern, W van Gijn, M Warmerdam, J van der Hem, M Lutke Holzik, I Masselink, L Morsink, R Klicks, M Stuijvenberg, M Pool, S de Castro, F Koremans, H C van der Wal, J Apers, E de Haan, M de Jongh, G de Klerk, R de Vos Tot Nederveen Cappel, P van Koperen, C Baeten, B Schaafsma, S Janki, V Kornmann, T van Sprundel

Affiliations

¹ Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
² Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
³ Department of Science and Research, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
⁴ Department of Biostatics, Erasmus MC, Rotterdam, the Netherlands.
⁵ Department of Surgery, Flevoziekenhuis, Almere, the Netherlands.
⁶ Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
⁷ Department of Surgery, Ikazia Hospital, Rotterdam, the Netherlands.

PMID: 39618338
DOI: 10.1111/codi.17217

Abstract

Aim: Managing pilonidal sinus disease (PSD) remains challenging due to high recurrence rates and morbidity associated with treatment. The aim of this study was to evaluate the outcomes one year after surgical treatment for chronic PSD in the Netherlands.

Method: Patients with PSD who underwent surgical treatment between March 1, 2020, and March 1, 2021, at 36 participating hospitals were included in a prospective observational cohort study. For the present study, only patients with chronic PSD were included for analysis. One-year after surgical treatment for PSD, all patients received questionnaires on wound healing, quality of life (QoL), and patient reported experience measures (PREMs). Primary outcome was recurrence rate. Secondary outcomes included QoL and PREMs.

Results: Of 681 included patients, 405 patients presented with chronic PSD and underwent surgical treatment. One-year questionnaires were completed by 289 out of 405 patients (71.4%). Patients underwent either excision with secondary wound healing (ESW, n = 73), excision with midline closure (EMC, n = 21), off-midline closure (OMC, n = 17), or a minimally invasive technique (MIT, n = 178). Patient-reported recurrence rates after ESW, EMC, OMC and MIT were 21.5%, 25%, 6.7% and 30.6%, respectively. Pain/discomfort and anxiety/depression were the most frequently reported problems affecting QoL. Patients that underwent OMC were satisfied the most with the care provided.

Conclusion: This study demonstrates variation in recurrence rates among surgical procedures for PSD. The highest rates were observed in the MIT and EMC group, while the OMC group exhibited the lowest rate. QoL outcomes differed among the surgical techniques. Patient satisfaction appears highest in the OMC group.

Keywords: excision with midline closure; excision with secondary wound healing; minimally invasive technique; off‐midline closure; patient reported experience measures; pilonidal sinus disease; quality of life; recurrence rate.