Prospective nationwide audit of short-term outcomes after surgery for chronic pilonidal sinus disease in the Netherlands.

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2025-06-11 DOI:10.1007/s10151-025-03159-7

E A Huurman, C A L de Raaff, R van den Berg, S J Baart, B P L Wijnhoven, R Schouten, E J B Furnée, B R Toorenvliet, R M Smeenk

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Abstract

Background: The optimal surgical approach for chronic pilonidal sinus disease (PSD) remains unclear, resulting in variation in surgical practice. This study aimed to provide an overview of PSD subtypes and assess practice variation and short-term outcomes.

Methods: A nationwide prospective observational cohort study was conducted. All patients with PSD and who underwent surgery were included during a 3-month inclusion period between March 1, 2020 and March 1, 2021. Primary endpoints were PSD classification and type and frequency of surgical approach. Secondary endpoints included symptoms, complications, recurrent open wounds, wound healing rate, time to wound healing, time to resume daily activities, reasons for selecting therapy, antibiotic prophylaxis, type of anesthesia, and hospital admission.

Results: A total of 36 hospitals participated in the study, and 405 patients had chronic disease. The median follow-up period was 42 days. Mean age was 28 years and 335 (82.7%) patients were male. Simple (n = 213) and complex PSD (n = 192) was equally common. Twelve different treatment modalities were performed. Minimally invasive techniques were used the most (61.2%) and off-midline closure in only a small proportion of patients (5.7%). Minimally invasive techniques showed a significantly higher wound healing rate (41.1% vs 28.6%) and a shorter median time to closure (41 vs 78 days) compared to excision with secondary healing. They also had the shortest median time to resume daily activities (14 days).

Conclusions: Simple and complex PSD were equally common. Practice variation in surgery is substantial. Minimally invasive techniques were most frequently performed and showed good short-term outcomes.

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荷兰慢性毛毛窦疾病手术后短期结果的前瞻性全国审计。

背景：慢性毛毛窦疾病（PSD）的最佳手术入路尚不清楚，导致手术实践的变化。本研究旨在提供PSD亚型的概述，并评估实践变化和短期结果。方法：在全国范围内进行前瞻性观察队列研究。所有接受手术的PSD患者均在2020年3月1日至2021年3月1日的3个月纳入研究。主要终点是PSD的分类、手术入路的类型和频率。次要终点包括症状、并发症、开放性伤口复发、伤口愈合率、伤口愈合时间、恢复日常活动时间、选择治疗的原因、抗生素预防、麻醉类型和住院情况。结果：共有36家医院参与研究，405例患者患有慢性疾病。中位随访期为42天。平均年龄28岁，男性335例（82.7%）。单纯性PSD （n = 213）和复合性PSD （n = 192）同样常见。采用12种不同的治疗方式。微创技术使用最多（61.2%），中线外闭合仅占一小部分（5.7%）。微创技术的创面愈合率（41.1%对28.6%）和愈合的中位时间（41天对78天）明显高于手术切除后的二次愈合。他们恢复日常活动的平均时间也最短（14天）。结论：简单和复杂PSD同样常见。外科手术的实践差异很大。微创技术是最常见的，并显示出良好的短期效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.