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Endoscopic Pilonidal Sinus Treatment Combined With Crystalized Phenol Application May Prevent Recurrence

Gecim, Ibrahim Ethem M.D.; Goktug, Utku Ufuk M.D.; Celasin, Haydar M.D.

Diseases of the Colon & Rectum: April 2017 - Volume 60 - Issue 4 - p 405–407
doi: 10.1097/DCR.0000000000000778
Original Contributions: Anorectal
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A link is provided from this article to a Letter to the Editor

BACKGROUND: No single treatment yet exists for pilonidal disease that has a short healing time, good cosmetic results, and a low rate of recurrence. Phenol crystal application and diathermy ablation through an endoscope have been used for the treatment of pilonidal disease, but this cohort is the first one to combine them.

OBJECTIVE: The purpose of this study was to examine the safety, effectiveness, and short- and long-term outcomes of crystalized phenol treatment combined with endoscopic pilonidal sinus treatment for pilonidal disease.

DESIGN: This was a prospective cohort study.

SETTINGS: Procedures were performed in 2 hospitals by the same surgeon between February and July 2014.

PATIENTS: Twenty-three patients underwent surgical treatment for pilonidal disease.

INTERVENTIONS: Under local anesthesia and sedation, all of the patients underwent a video-assisted diathermy ablation of the sinus cavity and the application of phenol crystals.

MAIN OUTCOME MEASURES: Adverse events were recorded as a measure of safety and tolerability. Failure to heal and recurrence rate were documented and evaluated.

RESULTS: Patients were discharged on the same day as surgery. There was no or minimal postoperative pain (mean visual analog scale score, 1.40 ± 0.95). Mean operation time was 20.43 ± 6.19 minutes, and the median return-to-work duration was 2.00 days (mean, 3.03 ± 2.95 d). Patients were followed-up for 18 to 24 months (mean, 22.00 ± 1.88 mo). No serious complications or rehospitalization were observed. No primary failure to heal or recurrence was observed.

LIMITATIONS: This study did not include a control group with which to compare and consisted of a relatively small number of patients.

CONCLUSIONS: Crystalized phenol treatment combined with endoscopic pilonidal sinus treatment was safe, tolerable, and achieved fast and durable healing with no recurrence over an average of 22 months of follow-up.

Supplemental Digital Content is available in the text.

1 Department of General Surgery, Ankara University Medical School, Ankara, Turkey

2 General Surgery Clinic, Akay Hastanesi, Ankara, Turkey

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML and PDF versions of this article on the journal’s Web site (www.dcrjournal.com).

Financial Disclosure: None reported.

Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Boston, MA, May 30 to June 3, 2015.

Correspondence: Ibrahim Ethem Gecim, M.D., Ankara University Medical School, Ibni Sina Hastanesi, K-4 Ankara, Turkey. E-mail: gecimethem@gmail.com

© 2017 The American Society of Colon and Rectal Surgeons