Finding the Perfect Spot: How Pits Location Shapes Surgical Choices in Chronic Sacrococcygeal Pilonidal Disease: Insights from a Specialized Center. | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 18, Issue 3, July 2025, Page 169-176 PDF (550.55 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asjs.2025.366038.1191 | ||||
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| Authors | ||||
Mohamed Balata  1; Mohamed Hamed Mohammed2; Ahmed Roushdy Mohamed2; Ahmed Abdelsamad3; Ahmed Fadaly Hussien2
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| 1Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura, Egypt | ||||
| 2General Surgery Department, Mansoura University Hospitals, Mansoura, Egypt | ||||
| 3Gastrointestinal and Oncological Surgery Department, Klinikum Vest, Recklinghausen, Germany, University Witten Herdecke, Surgery Department II, Germany | ||||
| Abstract | ||||
| Introduction: SPND can present with varying symptoms, from asymptomatic cases to severe infections and abscesses, or chronic inflammation with recurrent discharge. Aim of work: Various surgical techniques exist for managing chronic sacrococcygeal pilonidal disease, but standardization in choosing the appropriate procedure remains lacking. This study evaluates the choice of surgical technique based on pit location. Patients and methods: A comprehensive analysis of 107 patients was conducted at a tertiary center. Surgical technique selection was informed by the surgeon’s assessment of pit characteristics (Size, number, and location). Postoperative complications, one-year recurrence, and favourable outcomes were analysed. Results: Preoperative findings revealed differences among flap-based techniques regarding recurrence, lateral pit number, and pit distance from the midline. Postoperative outcomes varied significantly across techniques concerning healing time, drain removal, resumption of daily activity, and complications like flap ischemia and wound dehiscence. A 6.5% recurrence rate was observed, with 83.2% showing favourable outcomes. Delayed healing predicted recurrence, while pit distance from the midline predicted better outcomes. Conclusion: Patients with lateral pits up to 3 mm from the midline are suitable for primary closure. More lateral pits (Up to 20 mm) warrant rhomboid flaps, and those up to 30 mm are better managed with rotational flaps. | ||||
| Keywords | ||||
| Pilonidal disease; pits location; surgical option | ||||
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