Comparison of results of minimal invasive surgery for pilonidal sinus with Karydakis procedure: less is more

Aim: Controversy still remains regarding the best surgical technique to use for the treatment of pilonidal disease to minimize disease recurrence and patient discomfort. Minimal surgical procedures can be performed on an outpatient basis. In this study, the early results of our minimally invasive operative approach cases are compared with Karydakis flap reconstruction results. Material and methods: From January 11, 2012 to January 23, 2013, 312 patients were diagnosed with pilonidal sinus and treated in our clinic. Eighty-two of these patients (35 treated by a minimally invasive procedure (group I), 47 by the Karydakis flap procedure [Group II]) were included in the study. Data were collected by reviewing the patients’ records and by conducting telephone interviews. Results: The follow-up time of each case for Group I was 35 months and the average follow-up time was 32.5 months for Group II (interval, 24-40 months). Group I patients returned to work in 1 day; however, 40 patients (85.1%) in Group II returned in 20 days and 7 (14.9%) returned to work in 30 days. In group I, 32 patients (94%) were satisfied and 2 patients (5.7%) were not satisfied. In Group II, 32 patients (68.1%) were satisfied with the results of the surgical procedure and 15 patients (31.9%) were not satisfied. Our recurrence rates for group I and II were 5.7% and 6.4% for the first year, respectively. Conclusion: This indicated that the minimally invasive operative procedure can be performed with a low recurrence rate on a one day outpatient basis.