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Background <p>Pilonidal sinus disease (PSD) is common in young adults, yet real-world data integrating quality of life (QoL) with surgical outcomes are limited. We aimed to describe national surgical practice for PSD in Turkey and to compare complications, recurrence, and QoL between excision-based and non-excisional (minimally invasive) procedures.</p> Methods <p>This was a retrospective analysis of a prospectively maintained nationwide database including adults undergoing first surgery for PSD in 41 centers between January 2019 and January 2020. Sociodemographic and clinical data, perioperative variables, complications, and recurrence were recorded. QoL was assessed using the EQ-5D-5L (including EQ-VAS) and pain using a 10-point visual analog scale (VAS) at baseline and at postoperative day&#xa0;1, day&#xa0;7, 6&#xa0;months, and 12&#xa0;months. Patients were grouped according to surgical approach: simple excision, excision + flap and non-excisional procedures.</p> Results <p>Data from 1369 patients were analyzed (simple excision, <i>n</i> = 194; excision + flap, <i>n</i> = 983; non-excisional, <i>n</i> = 192). Overall, postoperative bleeding occurred in 12.3%, wound infection in 9.2%, and wound separation in 10.2% of patients, with wound separation being more frequent after excision + flap than non-excisional procedures. Recurrence at 12&#xa0;months was observed in 51 patients (3.7% overall), with rates of 3.1% in the simple excision group, 4.1% in the excision + flap group, and 2.6% in the non-excisional group (<i>p</i> = 0.545). Median pain VAS decreased from 4 (IQR 2–6) at baseline to 0 (0–0) at 12&#xa0;months in all groups (<i>p</i> &lt; 0.001 within groups). EQ-VAS improved by a median of 18 (IQR 8–40) points in the simple excision group, 15 (6–30) in the excision + flap group, and 29 (15–40) in the non-excisional group (<i>p</i> &lt; 0.001 between groups).</p> Conclusions <p>In this nationwide real-world cohort, non-excisional procedures were associated with shorter operative time, shorter hospital stay, fewer wound-related complications, and greater early improvements in QoL and patient satisfaction compared with excision-based procedures, without an apparent increase in 12-month recurrence. Given the retrospective design, baseline imbalances between groups, and limited follow-up, these findings should be confirmed in prospective comparative studies with longer follow-up.</p>

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Surgical preference and outcomes in pilonidal sinus disease: a national multicenter study evaluating complications, recurrence, and quality of life (PISI TURKEY)

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  • 发表日期：

    2026年3月16日

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  • Ali Yalcinkaya,
  • Ahmet Yalcinkaya,
  • Bengi Balci,
  • Can Sahin,
  • Elif Ozeller,
  • Ece Ozturk,
  • Gulsum Sueda Kayacan,
  • Berkay Enes Karaca,
  • Ahmet Faruk Oyanik,
  • Huseyin Gobut,
  • Cagri Buyukkasap,
  • Erdinc Kamer,
  • Sezai Leventoglu,
  • Alp Ozgun Borcek,
  • Omer Faruk Gul,
  • Basak Bolukbasi,
  • Aydin Yavuz,
  • Douigou Hasan,
  • Yasar Copelci,
  • Murat Kartal,
  • Serkan Tayar,
  • Mustafa Yeni,
  • Tolga Kalayci,
  • Ramazan Yavuz,
  • Bulent Calik,
  • Semra Demirli Atici,
  • Selen Ozturk,
  • Gizem Kilinc,
  • Korhan Tuncer,
  • Mustafa Yener Uzunoglu,
  • Alp Yildiz,
  • Aybala Yildiz,
  • Mehmet Caglikulekci,
  • Elbrus Zarbaliyev,
  • Murat Sevmis,
  • Baris Sevinc,
  • Nurullah Damburaci,
  • Omer Karahan,
  • Ozgen Isik,
  • Said Kural,
  • Xhenet Hysejni,
  • Ahmet Aktas,
  • Baris Yildiz,
  • Gultekin Ozan Kucuk,
  • Ahmet Can Sari,
  • Mert Candan,
  • Mehmet Mahir Ozmen,
  • Cem Emir Guldogan,
  • Emre Gundogdu,
  • Munevver Moran,
  • Mevlut Recep Pekcici,
  • Saygin Altiner,
  • Enes Cebeci,
  • Tugba Yigit,
  • Bedri Burak Sucu,
  • Omer Faruk Ozkan,
  • Hanife Seyda Ulgur,
  • Murat Kalin,
  • Emre Furkan Kirkan,
  • Abdullah Yildiz,
  • Mesut Ozogul,
  • Nihan Acar,
  • Melek Gokova Bekler,
  • Arif Atay,
  • Server Sezgin Uludag,
  • Ahmet Necati Sanli,
  • Sefa Ergun,
  • Ergin Erginoz,
  • Veysi Basbayandur,
  • Mehmet Faik Ozcelik,
  • Ahmet Askar,
  • Yuksel Altinel,
  • Adnan Hacim,
  • Serhat Meric,
  • Merve Tokocin,
  • Talar Aktokmakyan,
  • Yunus Aktimur,
  • Kamil Ozdogan,
  • Fikret Calikoglu,
  • Tugba Koc Calikoglu,
  • Ahmet Barcin,
  • Ahmed Salhat,
  • Guray Durmaz,
  • Volkan Ozben,
  • Erman Aytac,
  • Zumrud Aliyeva,
  • Arda Ulas Mutlu,
  • Mert Tanal,
  • Mustafa Fevzi Celayir,
  • Aydin Eray Tufan,
  • Ali Yuksel,
  • Elif Baran,
  • Banu Yigit,
  • Erhan Eroz,
  • Aykhan Abbasov,
  • Hakan Yanar,
  • Huseyin Onur Aydin,
  • Murathan Erkent,
  • Tugan Tezcaner,
  • Tevfik Avci,
  • Murat Kus,
  • Mehmet Abdussamet Bozkurt,
  • Adem Ozcan,
  • Nezihe Berrin Dodur Onalan,
  • Serhan Yilmaz,
  • Yasin Kara,
  • Ali Kocatas,
  • Fatih Yanar,
  • Ali Fuat Kaan Gok,
  • Irem Karatas,
  • Berke Sengun,
  • Ilknur Erenler Bayraktar,
  • Onur Bayraktar,
  • Zulal Emsal,
  • Irem Dalkilic,
  • Cengiz Dibekoglu,
  • Sami Acar,
  • Erman Ciftci,
  • Yunus Yapalak,
  • Cihad Tatar,
  • Mert Mahsuni Sevinc,
  • Ali Emre Nayci,
  • Egemen Saygili,
  • Yavuz Selim Komek,
  • Bayram Kaymak,
  • Fatih Altintoprak,
  • Emrah Akin,
  • Necattin Firat,
  • Emre Gonullu,
  • Ugur Can Dulger,
  • Atilla Kurt,
  • Sinan Soylu,
  • Musa Serin,
  • Omer Topcu,
  • Ali Cihat Yildirim,
  • Mehmet Fatih Ekici,
  • Sezgin Zeren,
  • Ismail Ahmet Bilgin,
  • Tayfun Karahasanoglu,
  • Ismail Hamzaoglu,
  • Afag Aghayeva,
  • Bilgi Baca,
  • Inci Sahin,
  • Osman Bozbiyik,
  • Mustafa Ozgur Kilincarslan,
  • Mustafa Ali Korkut,
  • Erhan Akgun,
  • Cemil Caliskan,
  • Tayfun Yoldas,
  • Timucin Erol,
  • Hilmi Anil Dincer,
  • Omer Cennet,
  • Muhammed Salih Suer,
  • Muhammet Bunyamin Dalkilic,
  • Ibrahim Alkan,
  • Busenur Kirimtay,
  • Emre Balik,
  • Emre Ozoran,
  • Ibrahim Halil Ozata,
  • Derya Salim Uymaz,
  • Tutku Tufekci,
  • Salih Nafiz Karahan,
  • Orhan Agcaoglu,
  • Naciye Cigdem Arslan,
  • Mehmet Yilmaz,
  • Orhan Ureyen,
  • Can Murat Kale,
  • Enver Ilhan,
  • Eray Kara,
  • Semra Tutcu Sahin,
  • Onur Haspolat,
  • Alperen Dalkiran,
  • Ergun Yuksel,
  • Mehmet Kocaoglu,
  • Emre Karaca,
  • Omer Tasan,
  • Cevdet Tokat,
  • Cihan Ozen,
  • Alptug Mertcan Koc,
  • Harun Karabacak,
  • Cem Azili,
  • Nurhak Cihangir Cinkil,
  • Hakan Sonmez,
  • Ismail Oskay Kaya

摘要

Background

Pilonidal sinus disease (PSD) is common in young adults, yet real-world data integrating quality of life (QoL) with surgical outcomes are limited. We aimed to describe national surgical practice for PSD in Turkey and to compare complications, recurrence, and QoL between excision-based and non-excisional (minimally invasive) procedures.

Methods

This was a retrospective analysis of a prospectively maintained nationwide database including adults undergoing first surgery for PSD in 41 centers between January 2019 and January 2020. Sociodemographic and clinical data, perioperative variables, complications, and recurrence were recorded. QoL was assessed using the EQ-5D-5L (including EQ-VAS) and pain using a 10-point visual analog scale (VAS) at baseline and at postoperative day 1, day 7, 6 months, and 12 months. Patients were grouped according to surgical approach: simple excision, excision + flap and non-excisional procedures.

Results

Data from 1369 patients were analyzed (simple excision, n = 194; excision + flap, n = 983; non-excisional, n = 192). Overall, postoperative bleeding occurred in 12.3%, wound infection in 9.2%, and wound separation in 10.2% of patients, with wound separation being more frequent after excision + flap than non-excisional procedures. Recurrence at 12 months was observed in 51 patients (3.7% overall), with rates of 3.1% in the simple excision group, 4.1% in the excision + flap group, and 2.6% in the non-excisional group (p = 0.545). Median pain VAS decreased from 4 (IQR 2–6) at baseline to 0 (0–0) at 12 months in all groups (p < 0.001 within groups). EQ-VAS improved by a median of 18 (IQR 8–40) points in the simple excision group, 15 (6–30) in the excision + flap group, and 29 (15–40) in the non-excisional group (p < 0.001 between groups).

Conclusions

In this nationwide real-world cohort, non-excisional procedures were associated with shorter operative time, shorter hospital stay, fewer wound-related complications, and greater early improvements in QoL and patient satisfaction compared with excision-based procedures, without an apparent increase in 12-month recurrence. Given the retrospective design, baseline imbalances between groups, and limited follow-up, these findings should be confirmed in prospective comparative studies with longer follow-up.