Annals of Coloproctology

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Benign GI diease,Benign proctology,Surgical technique

Pilonidal Sinus Management; Bascom Flap Versus Pilonidal Pits Excision: A Single-Center Experience: Ashraf Imam, Harbi Khalayleh, Guy Pines, Deeb Khoury, Eli Mavor, Arie Pelta; Ann Coloproctol. 2021;37(2):109-114. Published online November 6, 2020; DOI: https://doi.org/10.3393/ac.2019.11.19.2

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6 Web of Science
7 Citations

Purpose
This study aimed to evaluate the outcomes of the Bascom cleft lift (flap) and the pilonidal pits excision (Gips procedure).
Methods
The records of all the patients who underwent pilonidal sinus excision between November 2013 and August 2017 were reviewed. Inclusion criteria included either pilonidal pits excision or the Bascom cleft lift procedure. All procedures were performed by a single surgeon. Perioperative complications and recurrence rates were reviewed.
Results
Fifty-three patients met the inclusion criteria. Male/female ratio was 36/17, with a mean age of 23.4 ± 7 years. In this study, 21 patients underwent the Bascom cleft lift (skin flap) procedure and 32 underwent the Gips-style operation. The mean follow-up was 3.5 months. Twenty-eight patients (52.8%) underwent prior drainage of pilonidal abscess. Eleven patients had a previous wide local excision with recurrent disease. A higher rate of recurrence was observed among patients who underwent pits picking following failure of a previous wide local excision (80% vs. 0%, P = 0.02). Minor wound dehiscence developed in 8 patients; all of which were in the Bascom flap group (40% vs. 0%, P < 0.005). All of these wounds healed completely between 3 and 6 weeks.
Conclusion
The Gips procedure is the recommended treatment for simple pilonidal disease. For recurrent pilonidal disease, the Bascom cleft lift (flap) procedure is an excellent option since it demonstrates a short wound healing time and a good success rate. This calls into question the continued use of the wide excision technique used by most surgeons in this country and abroad.

Citations

Citations to this article as recorded by

Efficiency of the new modified inverted Y cleft lift advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease with low-lying tracts near the anus
Walid G. Elshazly, Ahmed Radwan, Mohmed A. Elhalim, Ahmed Moaz
The Egyptian Journal of Surgery.2024; 43(2): 548. CrossRef
ЭФФЕКТИВНОСТЬ КОЛЛАГЕНОВОЙ ГУБКИ ПРОПИТАННОЙ ДОКСИЦИКЛИНОМ ПРИ ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ПИЛОНИДАЛЬНОГО СИНУСА
G.A. Kosayeva
Azerbaijan Medical Journal.2024; (2): 16. CrossRef
Pilonidal diseases in children
Yu. Yu. Koinov, Yu. V. Chikinev, P. V. Trushin, A. I. Shevela, V. V. Sytkov, A. I. Khavkin
Experimental and Clinical Gastroenterology.2024; (10): 206. CrossRef
The application of the Limberg flap repair technique in the surgical treatment of pilonidal sinus disease
Yaoyao Song, Yu Zang, Zequn Chen, Jianjun Li, Minhui Zhu, Hongjuan Zhu, Wanli Chu, Gang Liu, Chuan'an Shen
International Wound Journal.2023; 20(6): 2241. CrossRef
Minimally invasive surgery for pilonidal disease: Outcomes of the Gips technique—A systematic review and meta-analysis
Marta Amorim, José Estevão-Costa, Cristina Santos, Sara Fernandes, Ana Catarina Fragoso
Surgery.2023; 174(3): 480. CrossRef
Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review
Peiliang Wu, Yingyi Zhang, Yewei Zhang, Shuang Wang, Zhe Fan
International Journal of Surgery.2023; 109(8): 2388. CrossRef
Minimally invasive treatment of pilonidal sinus disease in a paediatric population: comparison of two techniques
Sara Fernandes, Carolina Soares‐Aquino, Inês Teixeira, Joana Mafalda Monteiro, Miguel Campos
ANZ Journal of Surgery.2022; 92(12): 3288. CrossRef

Comparison of Limberg Flap and Karydakis Flap Surgery for the Treatment of Patients With Pilonidal Sinus Disease: A Single-Blinded Parallel Randomized Study: Mina Alvandipour, Mohammad Sadegh Zamani, Mojtaba Ghorbani, Jamshid Yazdani Charati, Mohammad Yasin Karami; Ann Coloproctol. 2019;35(6):313-318. Published online May 22, 2019; DOI: https://doi.org/10.3393/ac.2018.09.27

18,552 View
267 Download
15 Web of Science
24 Citations

Abstract PDF

Purpose
Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD.
Methods
A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study.
Results
Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group.
Conclusion
Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.

Citations

Citations to this article as recorded by

Short-term results of unroofing and marsupialization compared to the Karydakis technique in the treatment of pilonidal sinus. A randomized prospective study
Pedro Antonio Parra Baños, Nuria Martínez Sanz, Francisco Miguel González Valverde, Jorge Alejandro Benavides Buleje, Miguel Ruiz Marín, Emilio Peña Ros, Carmen Martínez Sanz, Mari Fe Candel Arenas
Cirugía Española (English Edition).2025; 103(1): 25. CrossRef
Resultados a corto plazo de la puesta a plano, curetaje y marsupialización frente a la técnica de Karydakis en el tratamiento del seno pilonidal. Estudio prospectivo aleatorizado
Pedro Antonio Parra Baños, Nuria Martínez Sanz, Francisco Miguel González Valverde, Jorge Alejandro Benavides Buleje, Miguel Ruiz Marín, Emilio Peña Ros, Carmen Martínez Sanz, Mari Fe Candel Arenas
Cirugía Española.2025; 103(1): 25. CrossRef
Langzeitergebnisse einer Pilotstudie über das zweizeitige Verfahren mit primärer Exzision und Limberg-Plastik im Intervall zur Therapie einer sakrokokzygealen Pilonidalsinuserkrankung
Michael Ardelt, Falk Rauchfuss, Felix Dondorf, Aladdin Ali Deeb, Astrid Bauschke, Oliver Rohland, Laura Schwenk, Utz Settmacher
Die Chirurgie.2025; 96(8): 667. CrossRef
Outcome After Surgical Treatment for Chronic Pilonidal Sinus Disease: A Systematic Review of Common Surgical Techniques
Ida-Marie Myron Wiinblad, Johan Ulrichsen, Birgitte Brandstrup
Diseases of the Colon & Rectum.2025; 68(5): 515. CrossRef
Midline and off-midline wound closure methods after surgical treatment for pilonidal sinus
Zhaolun Cai, Zhou Zhao, Qin Ma, Chaoyong Shen, Zhiyuan Jiang, Chunyu Liu, Chunjuan Liu, Bo Zhang
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
A new method for wound defect closure after pilonidal sinus excision
E. N. Shubrov, A G. Baryshev, K. V. Triandafilov
Koloproktologia.2024; 23(1): 129. CrossRef
The application of ERAS in pilonidal sinus: comparison of postoperative recovery between primary suture and Limberg flap procedure in a multicenter prospective randomized trial
Wei Lu, Shujuan Huang, Hui Ye, Shang Xiang, Xiangsheng Zeng
Frontiers in Surgery.2024;[Epub] CrossRef
Management and outcomes of pilonidal patients with secondary sinuses—a cohort study
Norah E. Liang, Claire Abrajano, Kyla Santos Dalusag, Bill Chiu
Pediatric Surgery International.2024;[Epub] CrossRef
Dutch national guideline on the management of intergluteal pilonidal sinus disease
Eleonora A Huurman, Christel A L de Raaff, Pim C E J Sloots, Oren Lapid, Hessel H van der Zee, Wilfred Bötger, Sandra Janssen, Francine Das, Andrea L J Kortlever-van der Spek, Anja van der Hout, Bas P L Wijnhoven, Boudewijn R Toorenvliet, Robert M Smeenk
British Journal of Surgery.2024;[Epub] CrossRef
Comparison of Outcome between Limberg Flap and Karydakis Flap in Pilonidal Sinus Disease
Madeeha Shahid, Muhammad Khalid, Nazia Qamar, Salman Zafar, Sadia Sundus, Abdul Rehman
Pakistan Journal of Health Sciences.2024; : 174. CrossRef
The application of the Limberg flap repair technique in the surgical treatment of pilonidal sinus disease
Yaoyao Song, Yu Zang, Zequn Chen, Jianjun Li, Minhui Zhu, Hongjuan Zhu, Wanli Chu, Gang Liu, Chuan'an Shen
International Wound Journal.2023; 20(6): 2241. CrossRef
Management of Pilonidal Disease
Lindsay A. Gil, Katherine J. Deans, Peter C. Minneci
JAMA Surgery.2023; 158(8): 875. CrossRef
Bilaterally parallel elliptic flap versus Karydakis flap in primary pilonidal sinus disease: a randomized controlled trial
Umut Fırat Turan, Serdar Coban, Tezcan Akin, Huseyin Berkem, Bulent Cavit Yuksel, Sadettin Er
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Evaluation of single center clinical experience in patients undergoing modified Limberg flap technique in pilonidal sinus disease
Burak UÇANER, Şebnem ÇİMEN, Mehmet Zeki BULDANLI
Journal of Medicine and Palliative Care.2023; 4(6): 694. CrossRef
Comparative Study on Short-Term Outcome in Patients Undergoing Pilonidal Sinus Surgery in Tertiary Care
Dakshay A. Chordia, A. P. Prem, Jameel Akhter, M. Muralidharan, A. Sathishkumar
Indian Journal of Colo-Rectal Surgery.2023; 6(1): 4. CrossRef
Analysis of the Outcomes of a New Method for Plastic Surgery for Postoperative Wound Of Sacrococcygeal Region after Excision of the Pilonidal Cyst: Randomized Trial.
E. N. Shubrov, A. G. Baryshev, K. V. Triandafilov, V. A. Aladina, V. V. Fedyushkin, R. K. Amirova
Kuban Scientific Medical Bulletin.2022; 29(5): 80. CrossRef
Effectiveness and Feasibility of Limberg and Karydakis Flap in Recurrent and Complicated Pilonidal Sinus Disease
Amr Abdel Hameed Elhiny, Doaa Ali Saad, Mohamed Sadek Farahat
Indian Journal of Surgery.2021; 83(1): 55. CrossRef
S3-Leitlinie: Sinus pilonidalis. 2. revidierte Fassung 2020
A. Ommer, I. Iesalnieks, D. Doll
coloproctology.2021; 43(S1): 25. CrossRef
Pilonoidal Sinüs Tedavisinde Modifiye Limberg Flep Uygulaması Sonuçları
Nizamettin KUTLUER, Nurullah AKSOY
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi.2021; 16(1): 68. CrossRef
Pilonidal Sinus Disease: An Analysis of the Factors Affecting Recurrence
Murat Kanlioz, Uğur Ekici, Faik Tatli, Turgay Karatas
Advances in Skin & Wound Care.2021; 34(2): 81. CrossRef
Karydakis procedure versus Limberg flap for treatment of pilonidal sinus: an updated meta-analysis of randomized controlled trials
Sameh Hany Emile, Sualeh Muslim Khan, Samer Hani Barsom, Steven D Wexner
International Journal of Colorectal Disease.2021; 36(7): 1421. CrossRef
Evaluation of comma-shaped incision with a sacral flap in surgical treatment of pilonidal sinus
MinaR.A.R. El Nahal, MohammedY.F. Aly, RagaiS Hanna, GamalA Makhlouf, GamalA Hameed Ahmed
Journal of Current Medical Research and Practice.2020; 5(1): 46. CrossRef
Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis
Siwei Bi, Kaibo Sun, Shanshan Chen, Jun Gu
Scientific Reports.2020;[Epub] CrossRef
An effective minimal invasive method in pilonidal sinus surgery: Sinusotomy
Önder KARABAY
Archives of Clinical and Experimental Medicine.2019; 4(3): 138. CrossRef

Rectourethral Fistula: Systemic Review of and Experiences With Various Surgical Treatment Methods: Ji Hye Choi, Byeong Geon Jeon, Sang-Gi Choi, Eon Chul Han, Heon-Kyun Ha, Heung-Kwon Oh, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Kyu Joo Park; Ann Coloproctol. 2014;30(1):35-41. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.35

10,611 View
141 Download
49 Web of Science
49 Citations

Abstract PDF

Purpose

A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation or trauma. Although various surgical procedures for the treatment of an RUF have been described, none has gained acceptance as the procedure of choice. The aim of this study was to review our experience with surgical management of RUF.

Methods

The outcomes of 6 male patients (mean age, 51 years) with an RUF who were operated on by a single surgeon between May 2005 and July 2012 were assessed.

Results

The causes of the RUF were iatrogenic in four cases (two after radiation therapy for rectal cancer, one after brachytherapy for prostate cancer, and one after surgery for a bladder stone) and traumatic in two cases. Fecal diversion was the initial treatment in five patients. In one patient, fecal diversion was performed simultaneously with definitive repair. Four patients underwent staged repair after a mean of 12 months. Rectal advancement flaps were done for simple, small fistula (n = 2), and flap interpositions (gracilis muscle flap, n = 2; omental flap, n = 1) were done for complex or recurrent fistulae. Urinary strictures and incontinence were observed in patients after gracilis muscle flap interposition, but they were resolved with simple treatments. The mean follow-up period was 28 months, and closure of the fistula was achieved in all five patients (100%) who underwent definitive repairs. The fistula persisted in one patient who refused further definitive surgery after receiving only a fecal diversion.

Conclusion

Depending on the severity and the recurrence status of RUF, a relatively simple rectal advancement flap repair or a more complex gracilis muscle or omental flap interposition can be used to achieve closure of the fistula.

Citations

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