Single Center Experience in Comparison of Crystalized Phenol and Surgical Excision in The Treatment of Pilonidal Sinus Disease

Research Article

Abstract

Introduction: Pilonidal sinus is a common disease of the sacrococcygeal region, usually seen in young men. In the treatment of this disease, there are minimally invasive methods as well as classical excisional surgical methods.

Objective: The aim of this study is to compare the postoperative morbidity and complications of conventional excision and flap closure versus curettage and crystallized phenol(CP), in the treatment of pilonidal sinus disease(PS), and to evaluate the effectiveness of crystallized phenol application in the treatment of PS.

Method: Medical records of patients who underwent sinus excision due to PS and patients who underwent crystallized phenol application for PS between January 2018 and December 2022 in our clinic were retrospectively evaluated. Two groups were formed by including patients who underwent PS excision with flap closure (e.g. Limberg, Karidakis) and patients who underwent curettage of the sinus area followed by CP application. Patients with unknown previous surgical history and those who could not be followed up postoperatively were not included in the study. A total of 240 patients in the excision group and 93 patients in the CP group were included in the study. Data regarding age at the time of surgery, gender, number of sinus orifices, history of abscess drainage, history of previous surgeries, recurrence after surgery, reoperation, wound site infection, and length of hospital stay were obtained for all patients.

Results: There was no significant difference in demographic characteristics between the two groups (p>0.05). Patients treated with CP had a lower number of sinus orifices compared to the excision group. The history of abscess drainage was significantly higher in the CP group (p<0.05). There was no statistically significant difference between the two groups regarding previous surgeries (p>0.05). Recurrence and the need for reoperation were significantly lower in the CP group (p<0.05). Patients in the CP group had lower surgical site infections after the procedure compared to the excision group(p<0.05).

Conclusion: Data from our analysis indicates that a minimally invasive approach for the treatment of PS is suitable for appropriate patients. This method is also associated with shorter hospital stay, lower recurrence and reoperation rates, and lower surgical site infection rates. Notably, previous sinus surgery and drainage do not preclude this method.