Paediatric Pilonidal Sinus Disease: Early Recurrences Irrespective of the Treatment Approaches in a Retrospective Multi-centric Analysis.

Autor: Maasewerd SKM; Klinik für Kinderchirurgie, St. Marien Hospital Bonn, Bonn, Germany.; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany., Stefanescu MC; Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin Mainz, Mainz, Germany., König TT; Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin Mainz, Mainz, Germany., Engels MN; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany., Rohleder S; Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin Mainz, Mainz, Germany., Schwind M; Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin Mainz, Mainz, Germany., Heydweiller AC; Klinik für Kinderchirurgie, St. Marien Hospital Bonn, Bonn, Germany.; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany., Oetzmann von Sochaczewski C; Sektion Kinderchirurgie der Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Germany. c.oetzmann@gmail.com.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2023 Sep; Vol. 47 (9), pp. 2296-2303. Date of Electronic Publication: 2023 May 18.
DOI: 10.1007/s00268-023-07045-x
Abstrakt: Background: Incidences of pilonidal sinus disease are rising. Guidelines rarely consider children and adolescents and evidence for their treatment is rare. The literature is divided on the choice of the preferable surgical procedure. Therefore, we aimed to assess recurrences and complications following different treatment approaches in our multi-centric cohort.
Methods: We retrospectively assessed all patients treated for pilonidal sinus disease in the paediatric surgical departments of Bonn and Mainz between 01/01/2009 and 31/12/2020. Recurrences were defined according to the German national guidelines. The pre-specified analysis via logistic regression included the operative approach, age, sex, use of methylene blue, and obesity as independent predictors.
Results: We included 213 patients, of which 13.6% experienced complications and 16% a recurrence. Median time to recurrence was 5.8 months (95% confidence interval: 4.2-10.3), which was slightly higher in children than adolescents (10.3 months, 95% confidence interval: 5.3-16.2 vs. 5.5 months, 95% confidence interval: 3.7-9.7). None of the investigated procedures, excision and primary closure, excision and open wound treatment, pit picking, and flap procedures had a decisive advantage in terms of complications or recurrence. Of the independent predictors, only obesity was associated to complications (adjusted odds ratio: 2.86, 95% confidence interval: 1.05-7.79, P = 0.04).
Conclusions: We did not find a difference between the investigated procedures, but our analysis is limited by the small sample size in some subgroups. Our data corroborates that recurrences in paediatric pilonidal sinus disease occur early. Factors linked to these differences remain unknown.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: