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Recurrence-free survival, but not surgical therapy per se, determines 583 patients’ long-term satisfaction following primary pilonidal sinus surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

With pilonidal sinus disease (PSD) incidence increasing and patients freely choosing their surgeon, patients’ interest issues have been brought forward estimating patient satisfaction following pilonidal sinus surgery. The influence of wound healing time and long-term recurrence rate on patient satisfaction in primary PSD surgery has not been investigated yet.

Methods

Five hundred eighty-three patients (German military cohort) were interviewed, compiling wound healing time, aesthetic satisfaction, long-term recurrence-free survival and patient satisfaction having undergone primary open (PO) treatment, marsupialization (MARS) or primary midline closure (PMC) treatment. Recurrence rate was determined by Kaplan-Meier calculation following up to 20 years after primary PSD surgery.

Results

Patient satisfaction ranking from 1 to 10 (10 = max. satisfied) showed an average satisfaction of 8.2 (range 0–10; 95 % confidence interval (CI) 7891–8250). In-hospital stay time was significantly longer in primary open (PO) and marsupialization (MARS) group as compared to primary midline closure (PMC; p < 0.0001, Kruskal-Wallis test). Satisfaction was comparable between treatment groups, and was neither linked to in-hospital stay time nor to longer outpatient wound care period or total treatment time. Recurrence-free survival, as seen in the PO and PMC treatment group, revealed a highly significant difference for all patients. Improvement in MARS patients with versus without recurrence was low, as satisfaction with primary treatment was lower as the other groups.

Conclusions

Neither choice of surgical treatment nor treatment duration within hospital or after hospital influences patient satisfaction, as long as recurrence-free survival can be provided. Marsupialization was ranked lower in both groups (with or without recurrence), and should be abandoned, as patients are significantly less satisfied with either results, independent of recurrence.

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Acknowledgments

This paper has not been submitted before anywhere else or now in parallel. It has not been presented fully or partially on a meeting or podium. It has not been published nor shown in beforehand.

Funding

None

Conflict of interest

The authors declare that they have no conflict of interest.

Authors’ contributions

Statistical analysis and calculations were done by PK and DD. Manuscript editing and interpretation of data were done by DD, MML, PK and EM. Manuscript writing was done by DD, EM, MML and PK. Graphic design was done by DD, MML and PK. Data acquisition was done by TE and DD.

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Authors and Affiliations

  1. Department of Surgery, Military Hospital Berlin, Academic teaching Hospital of the Charité, Berlin, Germany

    Dietrich Doll & Theo Evers

  2. Klinikum rechts der Isar, Department of Surgery, Technische Universität München, Munich, Germany

    Dietrich Doll & Edouard Matevossian

  3. Department of Anesthesiology and Pain Medicine, Bern University Hospital Inselspital, Bern, Switzerland

    Markus M. Luedi

  4. Institute of Applied Simulation, Zurich University of Applied Sciences (ZHAW), Waedenswil, Zurich, Switzerland

    Peter Kauf

  5. Department of General, Visceral, Vascular and Pediatric Surgery, Saarland University, Homburg / Saar, Germany

    Dietrich Doll

  6. Department of Surgery, St. Marien Hospital Vechta, Academic Teaching Hospital of the Hannover University, Marienstr. 6-8, 49377, Vechta, Germany

    Dietrich Doll

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  1. Dietrich Doll
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  2. Markus M. Luedi
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  3. Theo Evers
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  5. Edouard Matevossian
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Correspondence to Dietrich Doll.

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Doll, D., Luedi, M.M., Evers, T. et al. Recurrence-free survival, but not surgical therapy per se, determines 583 patients’ long-term satisfaction following primary pilonidal sinus surgery. Int J Colorectal Dis 30, 605–611 (2015). https://doi.org/10.1007/s00384-015-2130-0

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  • DOI: https://doi.org/10.1007/s00384-015-2130-0

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