The Correlation Between Delayed Surgical Therapy After the Diagnosis of Pilonidal Sinus Disease and Relapse, Labor Loss, and Costs.

Abstract

IntroductionThere has been no detailed study of the relationship between recurrence and symptom duration in pilonidal sinus disease. The aim of this study was to explore the correlation between delayed surgical therapy after symptoms appear in sacrococcygeal pilonidal sinus disease (SPSD) and relapse, labor loss and costs.MethodsPatients diagnosed with SPSD were split into two groups according to symptom duration before surgery: 30 days or less (G1) and more than 30 days (G2). Patients included those who underwent Limberg flap reconstruction (LFR) for primary SPSD. The length of hospitalization during surgery, postoperative follow-up period, and, if any, relapse periods were obtained from patients' files. Of the patients with incomplete information, only those whose information was confirmed by phone were also covered by the study.ResultsG1 included 153 patients, including 37 (24.18%) females and 116 (75.82%) males. The median age in G1 was 22 years and the mean age was 23.08±8.72 years. G2 included 214 patients, including 51 (23.83%) females and 163 (76.17%) males. The median age in G2 was 22 years and the mean age was 22.64±9.06 years. The mean lengths of hospitalization in G1 and G2 were 2.14±0.86 and 2.98±1.04 days, respectively, and the difference between them was significant (p<0.03). The follow-up periods in G1 and G2 were 61.52±29.84 (12-108) and 64.0±31.24 (12-113) months, respectively. Relapse occurred in nine patients (5.8%) in G1 and 19 patients (8.8%) in G2, and the difference between them was significant (p<0.02). The mean relapse period was 3.44±6.01 and 11.23±7.62 months in G1 and G2, respectively, and the difference between them was significant (p<0.04).ConclusionDelayed surgery should be avoided to minimize the costs and the probability of relapse in SPSD.