En bloc resection vs. Gips procedure in pilonidal sinus surgery.

Autores de IIS La Fe

• Irene Dieguez Hernandez-Vaquero

  Autor

• Adrià Costa Roig

  Autor

• José Antonio March Villalba

  Autor

• Maria Pilar Del Peral Samaniego

  Autor

• Alfredo Marco Macián

  Autor

• Juan José Vila Carbó

  Autor

Participantes ajenos a IIS La Fe

• Miró I

Grupos

• Hepatología experimental y Trasplante hepático

  Investigador Principal

  Laia Tolosa Pardo

• Investigación Clínica y Traslacional en Cáncer

  

  Leader

  José Gómez Codina

Abstract

INTRODUCTION: Pilonidal sinus (PS) is an infectious/inflammatory condition of the sacrococcygeal region, with frequent relapses. There is no clear consensus as to which management technique is best. The most widely used technique is en bloc resection (EBR), but less invasive methods (Gips procedure) are now being developed. OBJECTIVE: To compare complications and progression of pediatric patients undergoing PS surgery in our institution using two different surgical techniques. MATERIAL AND METHODS: A retrospective study of patients under 16 years of age undergoing PS surgery (EBR/Gips procedure) for the first time from 2014 to 2020 was carried out. Demographic variables, complications in the first month (exudate, wound infection, dehiscence, and bleeding), and result at the end of follow-up were collected. Qualitative variables were expressed as absolute frequency and percentage, whereas quantitative variables were expressed as mean and standard deviation. RESULTS: 60 patients underwent surgery. EBR was used in the first group, and the Gips procedure was used in the second group (76.67%, n = 46 vs. 23.33%, n = 14). Both were comparable in terms of sex (32.61% vs. 35.71% male), age (14.04 vs. 13.79 years old), and BMI (26.63 vs. 26.20 kg/m2) at surgery. 6 patients underwent re-intervention (10.87% vs. 7.14%; p = 0.684). Median follow-up time to healing was 6.13 ± 0.98 months vs. 3.31 ± 1.26 months (p < 0.024). The Gips procedure caused no dehiscence, whereas dehiscence rate in EBR was 65.22%. CONCLUSION: The Gips procedure is a minimally invasive alternative to EBR. It avoids dehiscence, and time to healing is shorter. Therefore, it should be regarded as the first-line treatment in PS patients.

Keywords

• Gips procedure; Pilonidal sinus