Evolution of surgical management in pilonidal disease: A 25-year scoping review and bibliometric analysis of pediatric and adult literature

IF 2.3 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2026-12-01 Epub Date: 2026-10-01 DOI:10.1016/j.jpedsurg.2026.163513

Anam N. Ehsan, Rafia Durrani, Kevin Flores, Claire Abrajano, Bill Chiu

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引用次数: 0

Abstract

Background

Pilonidal disease is a chronic inflammatory condition of the sacrococcygeal region that disproportionately affects adolescents and young adults. Although numerous treatment approaches exist, optimal management remains debated and practice patterns vary widely. How pediatric treatment strategies and research priorities have evolved relative to adult literature remains incompletely understood.

Methods

A scoping review and bibliometric analysis were conducted to evaluate trends in surgical management of pilonidal disease from 2000 to 2025. A systematic PubMed search identified studies reporting clinical data on pilonidal disease treatment. Extracted data included publication year, origin country, patient population, treatment modality, recurrence outcomes, and follow-up duration. Bibliometric analysis assessed publication trends, geographic distribution, and thematic evolution using keyword co-occurrence mapping.

Results

A total of 383 studies were included – 327 adult (85%) and 56 pediatric (15%) studies. Publication volume increased steadily over time, with pediatric literature expanding after 2015. Adult studies originated from 36 countries compared with 12 countries in pediatric literature, with no pediatric studies from low- or middle-income countries identified. Operative-only approaches predominated in adult literature (80% vs 61%, p < 0.001), while pediatric studies more frequently evaluated minimally invasive and multimodal strategies. Keyword analysis demonstrated temporal evolution from excisional surgery and flap reconstruction toward minimally invasive and adjunctive therapies.

Conclusions

Research on pilonidal disease surgery has increased but remains heterogeneous in treatment strategies and research focus. Pediatric literature represents a small but evolving portion of the evidence base and increasingly explores minimally invasive approaches. Greater standardization and broader international collaboration are needed to develop consistent evidence-based management strategies.

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毛鞘疾病外科治疗的演变：25年来儿科和成人文献的范围回顾和文献计量学分析。

背景：毛鞘病是骶尾骨区域的一种慢性炎症性疾病，主要影响青少年和年轻人。尽管存在许多治疗方法，但最佳管理仍存在争议，实践模式差异很大。相对于成人文献，儿科治疗策略和研究重点是如何演变的仍不完全清楚。方法：对2000年至2025年毛鞘疾病手术治疗的趋势进行范围回顾和文献计量学分析。系统的PubMed检索确定了报告毛鞘疾病治疗临床数据的研究。提取的数据包括出版年份、原产国、患者人群、治疗方式、复发结果和随访时间。文献计量分析评估出版趋势，地理分布和专题演变使用关键词共现图。结果：共纳入383项研究——327项成人研究（85%）和56项儿科研究（15%）。随着时间的推移，出版物数量稳步增长，2015年后儿科文献不断扩大。成人研究来自36个国家，而儿科文献中只有12个国家，没有发现来自低收入或中等收入国家的儿科研究。在成人文献中，单纯手术方法占主导地位（80%比61%）。结论：对毛鞘疾病手术的研究有所增加，但在治疗策略和研究重点上仍存在差异。儿科文献代表了一小部分但不断发展的证据基础，并越来越多地探索微创方法。需要加强标准化和更广泛的国际合作，以制定一致的循证管理战略。

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

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.