Background: According to the Italian Society of Colorectal Surgery guidelines, the most effective approach to the pilonidal abscess is adequate surgical drainage, concerning incision and drainage of the pilonidal cavity. Few recent studies have demonstrated that endoscopic approach could be a valid treatment option even in the case of acute pilonidal abscess. The aim of our study is to assess if video-assisted ablation of pilonidal sinus (VAAPS) could be an alternative to treat an acute pilonidal abscess and to evaluate if an immediate endoscopic approach to the pilonidal abscess is preferable to a delayed procedure after incision and drainage. Methods: All consecutive patients with an acute pilonidal abscess since 1 January 2014 to 31 December 2018 were enrolled in our propensity score-matched analysis and divided into two groups: the early VAAPS group and the delayed VAAPS group. Primary outcomes were recurrence rate at 1-year, 3-year, and 5-year follow-up. Secondary outcomes were time off, time to wound healing, incomplete wound healing, perioperative infection, patients’ satisfaction 1 month after the complete wound healing, and their health status before surgery and 6 months after complete wound healing. Results: After the propensity score matching, 82 patients were included in the final analysis (41 in each group). No differences were found in terms of recurrence in the two groups. Early endoscopic approach was associated with a better patients’ satisfaction (8.17 ± 1.2 vs 6.06 ± 1.48, p = 0.001) and a better postoperative health status (86.27 ± 6.54 vs 77.32 ± 5.85, p = 0.001). Conclusions: Our results encouraged to perform an immediate endoscopic approach to an acute pilonidal abscess.

Early versus delayed endoscopic treatment of acute pilonidal abscess: a propensity score-matched analysis / Manigrasso, M.; Velotti, N.; Sosa Fernandez, L. M.; Vertaldi, S.; Maione, F.; Gennarelli, N.; Schettino, P.; Musella, M.; De Palma, G. D.; Milone, M.. - In: INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. - ISSN 0179-1958. - 36:2(2021), pp. 339-345. [10.1007/s00384-020-03767-9]

Early versus delayed endoscopic treatment of acute pilonidal abscess: a propensity score-matched analysis

Manigrasso M.;Velotti N.;Sosa Fernandez L. M.;Vertaldi S.;Maione F.;Musella M.;De Palma G. D.;Milone M.
2021

Abstract

Background: According to the Italian Society of Colorectal Surgery guidelines, the most effective approach to the pilonidal abscess is adequate surgical drainage, concerning incision and drainage of the pilonidal cavity. Few recent studies have demonstrated that endoscopic approach could be a valid treatment option even in the case of acute pilonidal abscess. The aim of our study is to assess if video-assisted ablation of pilonidal sinus (VAAPS) could be an alternative to treat an acute pilonidal abscess and to evaluate if an immediate endoscopic approach to the pilonidal abscess is preferable to a delayed procedure after incision and drainage. Methods: All consecutive patients with an acute pilonidal abscess since 1 January 2014 to 31 December 2018 were enrolled in our propensity score-matched analysis and divided into two groups: the early VAAPS group and the delayed VAAPS group. Primary outcomes were recurrence rate at 1-year, 3-year, and 5-year follow-up. Secondary outcomes were time off, time to wound healing, incomplete wound healing, perioperative infection, patients’ satisfaction 1 month after the complete wound healing, and their health status before surgery and 6 months after complete wound healing. Results: After the propensity score matching, 82 patients were included in the final analysis (41 in each group). No differences were found in terms of recurrence in the two groups. Early endoscopic approach was associated with a better patients’ satisfaction (8.17 ± 1.2 vs 6.06 ± 1.48, p = 0.001) and a better postoperative health status (86.27 ± 6.54 vs 77.32 ± 5.85, p = 0.001). Conclusions: Our results encouraged to perform an immediate endoscopic approach to an acute pilonidal abscess.
2021
Early versus delayed endoscopic treatment of acute pilonidal abscess: a propensity score-matched analysis / Manigrasso, M.; Velotti, N.; Sosa Fernandez, L. M.; Vertaldi, S.; Maione, F.; Gennarelli, N.; Schettino, P.; Musella, M.; De Palma, G. D.; Milone, M.. - In: INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. - ISSN 0179-1958. - 36:2(2021), pp. 339-345. [10.1007/s00384-020-03767-9]
File in questo prodotto:
File Dimensione Formato  
Sinus 2020.pdf

Open Access dal 01/03/2022

Tipologia: Versione Editoriale (PDF)
Licenza: Accesso privato/ristretto
Dimensione 365.91 kB
Formato Adobe PDF
365.91 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/823987
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 7
social impact