Surgical Outcomes of Minimally Invasive Trephine Surgery for Pilonidal Sinus Disease and Risk Factors for Recurrence

Background: Minimally invasive surgical (MIS) techniques for pilonidal sinus disease (PNS) have gained popularity in recent years, due to faster recovery and lower complication rate compared with conventional methods. Our aim was to assess recurrence rate following MIS Trephine procedure for PNS and to identify possible risk factors for recurrence. Materials and Methods: A prospective cohort, including patients who underwent PNS Excision by Trephine MIS Procedure over 5 years in a large tertiary medical center was established. Patient data were collected from medical charts and patient telephone survey to asses recurrence rate. Results: Two hundred three patients underwent MIS Trephine procedure for PNS, with data available on 130 patients (64.2%). Overall recurrence and nonhealing wound rate was 33.07% (43 patients), with disease recurrence occurring in mean time of 13.3 months (range 2-47 months). Thirty-six patients underwent repeat MIS Trephine surgery with recurrence occurring in 6 patients (4.6%). Overall healing rate following repeat surgery was 91.5% (119 patients). Univariate analysis of preoperative and clinical factors, including body mass index (P = .77), smoking status (P = .53), number of sinus tracts (P = .78), previous abscess drainage (P = .45), and diameter size of the trephine blade (P = .72) demonstrated no correlation to disease recurrence following surgery. Multivariate Cox regression analysis showed similar results, with only young age (<30 years) associated with disease recurrence (P = .01). Conclusion: Recurrence following minimally invasive trephine excision for PNS is fairly high, but repeat surgery in recurring patients has a high rate of a successful outcome.