Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease

M Milone,M Pozzo,M Manigrasso,R Pietroletti,A Bondurri,R Perinotti,L Basso,D Segre,G Milito,G Gallo,M La Torre

doi:10.1007/s10151-021-02487-8

Abstract

Pilonidal disease (PD) is a relatively common, benign but challenging condition of the natal cleft. This consensus statement was drawn up by a panel of surgeons, identified by the Italian Society of Colorectal Surgery (SICCR) as having a “special interest” in PD, with the aim of recommending the best therapeutic options according to currently available scientific evidence. A three-step modified-Delphi process was adopted, implying: (1) choice of the panelists; (2) development of a discussion outline and of target issues; and (3) a detailed systematic review of the current literature. The agreement/disagreement level was scored on a five-point Likert scale as follows: “A + : strongly agree; A–: agree; N: unsure/no opinion; D–: disagree; D + : strongly disagree. Each panelist contributed to the production of this manuscript, and the final recommendations were reviewed by the Clinical Practice Guidelines Committee.

Highlights

Pilonidal disease (PD) is a relatively common, benign but challenging condition, normally, albeit not exclusively [1], involving the natal cleft
The present consensus statement was drawn up based on the opinion of a panel composed of surgeons identified by the Italian Society of Colorectal Surgery (SICCR) as having a special interest in PD, with the aim of identifying the best therapeutic option(s) to treat PD, according to currently available scientific evidence
To ensure the inclusion of all available studies, a detailed search for PD was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE) with several combinations of keywords: pilonidal sinus, pilonidal sinus disease, etiology, risk factors, diagnosis, surgery, open healing, VAC-therapy, drainage, midline, off-midline, flap, Limberg, Karydakis, minimally invasive treatment, sinusectomy, sinotomy, Gips, endoscopic pilonidal sinus treatment (EPSiT), video-assisted ablation of pilonidal sinus (VAAPS), satisfaction, recurrence, infection, epilation

Summary

Introduction

Pilonidal disease (PD) is a relatively common, benign but challenging condition, normally, albeit not exclusively [1], involving the natal cleft. PD afflicts around 26 people in 100,000 [2], and its ideal treatment is controversial. In 2015, the Italian Society of Colorectal Surgery (SICCR) issued treatment guidelines [3], inspired by those of the American Society of Colorectal Surgeons [4]. The current surgical arena has been recently enriched by relatively new. 2 “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, viale del Policlinico 155, 00161 Rome, Italy

Methodology

Conclusions

Findings

82. SICCR Pilonidalis Study Group