Minimally invasive surgery for pilonidal disease: Outcomes of the Gips technique-A systematic review and meta-analysis.

Autor: Amorim M; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal. Electronic address: martabcba@gmail.com., Estevão-Costa J; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal., Santos C; CINTESIS@RISE, Faculty of Medicine of the University of Porto, Portugal., Fernandes S; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal., Fragoso AC; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2023 Sep; Vol. 174 (3), pp. 480-486. Date of Electronic Publication: 2023 Jul 05.
DOI: 10.1016/j.surg.2023.05.035
Abstrakt: Background: Pilonidal disease is a common inflammatory condition that significantly impacts quality of life. Currently, there is a tendency to favor minimally invasive procedures. The present review aims to summarize the evidence and assess the outcomes of the Gips procedure.
Methods: A systematic review was conducted on MEDLINE/Pubmed, Scopus, Web of Science, and Cochrane Library databases until December 2022. Eligible studies included patients with pilonidal disease submitted to the Gips procedure, reporting at least 1 of the following outcomes: wound complications, wound healing time, time to resume daily activities, and recurrence (International Prospective Register of Systematic Reviews protocol: CRD42023389269). The National Institutes of Health assessment tool was used for risk of bias evaluation. Meta-analysis was performed using OpenMeta[Analyst] and R software, and a subgroup analysis was performed when applicable.
Results: Thirteen observational studies with a total of 4,286 patients submitted to Gips were included. The pooled wound complications rate was 7.8% (95% confidence interval: 5.1-10.6), the median time to resume daily activities was 1 day (95% confidence interval: 1-2), and the mean wound healing time was 4.7 weeks (95% confidence interval: 3.0-6.4). Subgroup analysis showed that pooled recurrence rate was 6.5% (95% confidence interval: 5.2-7.8) up to 2 years and 38.9% (95% confidence interval: 27.1-50.7) after more than 2 years of surgery. Most results showed substantial heterogeneity across studies.
Conclusion: Despite apparent favorable outcomes of the Gips procedure, there is a high recurrence rate over time. Because included studies had an observational nature and unstandardized methodologies, comparative randomized controlled trials with longer follow-ups are needed for high-level evidence regarding these outcomes.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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