Surgical Treatment of the Pilonidal Disease - Short-term Follow Up Results of Minimally Invasive Pit-Picking Surgery Versus Radical Excision Without Suturing: A Prospective Randomised Trial

Background In this study we compared the potential benefits of surgical treatments for chronic symptomatic pilonidal disease (PD) - minimally invasive pit-picking surgery and radical excision without wound suturing. Materials and Methods A total of 100 adult patients with chronic symptomatic PD were enrolled in this study at the Kaunas Hospital of the Lithuanian University of Health Sciences. They were randomly divided into two groups: pit-picking surgery (n = 50) and radical excision with open healing (n = 50). Recurrent PD patients were not excluded. The comparison was based on pain within the first postoperative week, recurrence rates, and wound healing time. Additionally, pain levels at different time intervals following the treatment, analgesic consumption, and time off work, were assessed and compared. Results 89 patients (89%) were available for a follow-up after 6 months. Pain levels the first postoperative week were significantly lower in the pit-picking group compared to the radical excision group, with median scores of 10.0 and 20.0, respectively (p = 0.002). The complete wound healing time was longer in the radical excision group (60 days) versus pit-picking group (17 days), with a significant difference (p = 0.00). No significant difference was observed between the type of surgery and the recurrence rate, with 5 (11.9%) cases in the pit-picking group and 4 (8.5%) in the radical excision group. Conclusion Based on the short-term findings, minimally invasive pit-picking surgery could be a better option regarding pain and wound healing time. It might be advisable to reserve radical surgery without wound suturing for exceptional cases.