Resultados a corto plazo de la puesta a plano, curetaje y marsupialización frente a la técnica de Karydakis en el tratamiento del seno pilonidal. Estudio prospectivo aleatorizado

Abstract

Introduction

The treatment of pilonidal sinus (PS) is usually surgical, but no procedure is considered the gold standard. The Karydakis (K) technique is widely used, and unroofing and marsupialization (UM) is a simple surgery with good results.

Primary objective

To evaluate early postoperative complications (EPC) 30 days after UM surgery compared to the K technique.

Secondary objectives

To evaluate surgical time, postoperative pain, patient satisfaction, return to daily activity and early recurrence within 3 months.

Method

Prospective, single-center, randomized study in patients who underwent surgery for primary PS with no abscess between June 2016 and November 2017. They were randomized using a computer-generated block method. To analyze the main objective, a non-inferiority analysis was performed.

Results

One hundred twenty-two patients with symptomatic primary PS were randomized: 60 in the K group and 62 in the UM group. Both groups were homogeneous.

There were statistically significant differences between surgery and postoperative complications at 15 and 30 days in favor of UM. There were also differences in favor of UM in surgical time and return to daily activity. During the 90-day follow-up, there were three recurrences in the UM group and 0 in the K group.

Conclusions

UM is a simple, minimally invasive, easily reproducible technique that has a lower rate of early complications, with a shorter operative time and an earlier return to daily activity.