Araştırma Makalesi
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Is Pathological Assessment Necessary for Excised Sacrococcygeal Pilonidal Sinus Specimens?

Yıl 2021, Cilt: 43 Sayı: 4, 403 - 406, 18.05.2021
https://doi.org/10.20515/otd.894255

Öz

In some surgical methods, the cavity of the sacrococcygeal pilonidal sinus remains in the patient. This situation leads us to question the necessity of routine pathological examination. Patients undergoing surgical excision for sacrococcygeal pilonidal sinus between January 2016 and March 2020 at Gaziantep Dr. Ersin Arslan Training and Research Hospital were retrospectively screened. Patients with pilonidal sinus in the non-sacrococcygeal region and patients with minimally invasive treatment and without histopathological examination were excluded. Gender, age, operation notes, and pathology results of the patients were analyzed. For all patients, an excision plus flap (Limberg or Karydakis) procedure was performed and the specimen was sent to routine histopathological examination. Of 1971 patients who underwent surgery for sacrococcygeal pilonidal sinus, 1551 (79%) were male and 420 (21%) were female, with an average age of 24 years (13-66). None of the pathological findings revealed any malignancy. The rate of malignancy reported in the literature is not in concordance with minimally invasive procedures in which pathology samples are not taken. Except in cases of prolonged duration of disease, elderly age, macroscopic suspicion, or recurrence, we believe that routine pathological examination of the pilonidal sinus may be unnecessary.

Kaynakça

  • Referans1-Shabbir J, Chaudhary BN, Britton DC. Management of sacrococcygeal pilonidal sinus disease: a snapshot of current practice.Int J Colorectal Dis 2011;26:1619-20.
  • Referans2- Michalopoulos N, Sapalidis K, Laskou S et al. Squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease: a case report. World J Surg Oncol 2017;15:65.
  • Referans3- Kober MM, Alapati U, Khachemoune A. Treatment options for pilonidal sinus. Cutis 2018;102:E23-E29.
  • Referans4- Eryilmaz R, Bilecik T, Okan I et al. Recurrent squamous cell carcinoma arising in a neglected pilonidal sinus: report of a case and literature review. Int J Clin Exp Med 2014;7:446-50.
  • Referans5- Pandey MK, Gupta P, Khanna AK. Squamous cell carcinoma arising from pilonidal sinus. Int Wound J 2014;11:354-6.
  • Referans6- Parpoudi SN, Kyziridis DS, Patridas DCh et al. Is histological examination necessary when excising a pilonidal cyst? Am J Case Rep 2015;16:164-8.
  • Referans7- Yuksel ME, Tamer F. All pilonidal sinus surgery specimens should be histopathologically evaluated in order to rule out malignancy. J Visc Surg 2019;156:469-70.
  • Referans8- Boulanger G, Abet E, Brau-Weber AG et al. Is histological analysis of pilonidal sinus useful? Retrospective analysis of 731 resections. J Visc Surg 2018;155:191-4.
  • Referans9- Dag A, Colak T, Turkmenoglu O et al. Phenol procedure for pilonidal sinus disease and risk factors for treatment failure. Surgery 2012;151:113-7.
  • Referans10- Kalaiselvan R, Bathla S, Allen W et al. Minimally invasive techniques in the management of pilonidal disease. Int J Colorectal Dis 2019;34:561-8.
  • Referans11- Dessily M, Charara F, Ralea S et al. Pilonidal sinus destruction with a radial laser probe: technique and first Belgian experience. Acta Chir Belg 2017;117:164-8.
  • Referans12- Hoehn GH. A simple solution to the therapeutic dilemma of pilonidal cysts. J Dermatol Surg Oncol 1982;8:56-7.
  • Referans13- Cevik M, Dorterler ME, Abbasoglu L. Is conservative treatment an effective option for pilonidal sinus disease in children? Int Wound J 2018;15:840-4.
  • Referans14- von Elm E, Altman DG, Egger M et al. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 2014;12:1495-9.
  • Referans15- Adanali G, Senen D, Tuncel A et al. Squa-mous cell carcinoma developing in a pilonidal sinus. Plast Reconstr Surg 2002;110:1367-8.
  • Referans16- Chatzis I, Noussios G, Katsourakis A et al. Squamous cell carcinoma related to long standing pilonidal-disease. Eur J Dermatol 2009;19:408-9.
  • Referans17- Johnson EK, Vogel JD, Cowan ML et al. Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease. Dis Colon Rectum 2019;62:146-57.
  • Referans18- Yuksel ME, Ordu M. Pilonidal disease specimens of 905 patients revealed no malignancy, however we still insist on histopathological examination. Ann Med Res 2020;27:810-3.
  • Referans19- Iesalnieks I, Ommer A. The Management of Pilonidal Sinus. Dtsch Arztebl Int 2019;116:12-21.
  • Referans20- Bascom J. Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery 1980;87: 567-72.
  • Referans21- Konrad Wroński KX. A rare case of squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease. Ann Ital Chir 2019;8.
  • Referans22- Delvecchio A, Laforgia R, Sederino MG et al. Squamous carcinoma in pilonidalis sinus: case report and review of literature. G Chir 2019;40:70-4.
  • Referans23- Sharma D, Pratap A, Ghosh A et al. Malignant transformation of a pilonidal sinus. Surgery 2009;145:243-4.

Sakrokoksigeal Pilonidal Sinüs Spesmenlerinde Patolojik Değerlendirme Gerekli midir?

Yıl 2021, Cilt: 43 Sayı: 4, 403 - 406, 18.05.2021
https://doi.org/10.20515/otd.894255

Öz

Pilonidal sinüsün bazı cerrahi yöntemlerinde hastada sakrokoksigeal pilonidal sinüs boşluğu kalmaktadır ve bu durum bizi patolojik incelemenin gerekliliğini sorgulamaya yöneltmiştir. Ocak 2016-Mart 2020 tarihleri arasında Gaziantep Dr. Ersin Arslan Eğitim ve Araştırma Hastanesi'nde sakrokoksigeal pilonidal sinüs için cerrahi eksizyon uygulanan hastalar retrospektif olarak tarandı. Sakrokoksigeal bölge dışındaki pilonidal sinüsü olan hastalar, minimal invaziv tedavi gören ve histopatolojik incelemesi olmayan hastalar çalışma dışı bırakıldı. Hastaların cinsiyeti, yaşı, ameliyat notları ve patoloji sonuçları analiz edildi. Tüm hastalara eksizyon artı flep (Limberg veya Karydakis) prosedürü uygulandı ve spesmenler rutin histopatolojik incelemeye gönderildi. Sakrokoksigeal pilonidal sinüs nedeniyle ameliyat edilen 1971 hastanın 1551'I (% 79) erkek, 420'si (% 21) kadındı ve yaş ortalaması 24 (13-66) idi. Patolojik bulguların hiçbiri malignite göstermedi. Literatürde bildirilen malignite oranı, patoloji örneklerinin alınmadığı minimal invaziv prosedürlerle uyumlu değildir. Uzun süreli hastalık, yaşlılık, makroskopik şüphe veya nüks durumları dışında pilonidal sinüsün rutin patolojik incelemesinin gereksiz olabileceğine inanıyoruz.

Kaynakça

  • Referans1-Shabbir J, Chaudhary BN, Britton DC. Management of sacrococcygeal pilonidal sinus disease: a snapshot of current practice.Int J Colorectal Dis 2011;26:1619-20.
  • Referans2- Michalopoulos N, Sapalidis K, Laskou S et al. Squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease: a case report. World J Surg Oncol 2017;15:65.
  • Referans3- Kober MM, Alapati U, Khachemoune A. Treatment options for pilonidal sinus. Cutis 2018;102:E23-E29.
  • Referans4- Eryilmaz R, Bilecik T, Okan I et al. Recurrent squamous cell carcinoma arising in a neglected pilonidal sinus: report of a case and literature review. Int J Clin Exp Med 2014;7:446-50.
  • Referans5- Pandey MK, Gupta P, Khanna AK. Squamous cell carcinoma arising from pilonidal sinus. Int Wound J 2014;11:354-6.
  • Referans6- Parpoudi SN, Kyziridis DS, Patridas DCh et al. Is histological examination necessary when excising a pilonidal cyst? Am J Case Rep 2015;16:164-8.
  • Referans7- Yuksel ME, Tamer F. All pilonidal sinus surgery specimens should be histopathologically evaluated in order to rule out malignancy. J Visc Surg 2019;156:469-70.
  • Referans8- Boulanger G, Abet E, Brau-Weber AG et al. Is histological analysis of pilonidal sinus useful? Retrospective analysis of 731 resections. J Visc Surg 2018;155:191-4.
  • Referans9- Dag A, Colak T, Turkmenoglu O et al. Phenol procedure for pilonidal sinus disease and risk factors for treatment failure. Surgery 2012;151:113-7.
  • Referans10- Kalaiselvan R, Bathla S, Allen W et al. Minimally invasive techniques in the management of pilonidal disease. Int J Colorectal Dis 2019;34:561-8.
  • Referans11- Dessily M, Charara F, Ralea S et al. Pilonidal sinus destruction with a radial laser probe: technique and first Belgian experience. Acta Chir Belg 2017;117:164-8.
  • Referans12- Hoehn GH. A simple solution to the therapeutic dilemma of pilonidal cysts. J Dermatol Surg Oncol 1982;8:56-7.
  • Referans13- Cevik M, Dorterler ME, Abbasoglu L. Is conservative treatment an effective option for pilonidal sinus disease in children? Int Wound J 2018;15:840-4.
  • Referans14- von Elm E, Altman DG, Egger M et al. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 2014;12:1495-9.
  • Referans15- Adanali G, Senen D, Tuncel A et al. Squa-mous cell carcinoma developing in a pilonidal sinus. Plast Reconstr Surg 2002;110:1367-8.
  • Referans16- Chatzis I, Noussios G, Katsourakis A et al. Squamous cell carcinoma related to long standing pilonidal-disease. Eur J Dermatol 2009;19:408-9.
  • Referans17- Johnson EK, Vogel JD, Cowan ML et al. Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease. Dis Colon Rectum 2019;62:146-57.
  • Referans18- Yuksel ME, Ordu M. Pilonidal disease specimens of 905 patients revealed no malignancy, however we still insist on histopathological examination. Ann Med Res 2020;27:810-3.
  • Referans19- Iesalnieks I, Ommer A. The Management of Pilonidal Sinus. Dtsch Arztebl Int 2019;116:12-21.
  • Referans20- Bascom J. Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery 1980;87: 567-72.
  • Referans21- Konrad Wroński KX. A rare case of squamous cell carcinoma arising from chronic sacrococcygeal pilonidal disease. Ann Ital Chir 2019;8.
  • Referans22- Delvecchio A, Laforgia R, Sederino MG et al. Squamous carcinoma in pilonidalis sinus: case report and review of literature. G Chir 2019;40:70-4.
  • Referans23- Sharma D, Pratap A, Ghosh A et al. Malignant transformation of a pilonidal sinus. Surgery 2009;145:243-4.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Ufuk Uylaş 0000-0003-4195-5498

Ramazan Gündoğdu 0000-0002-8799-3265

Yayımlanma Tarihi 18 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 43 Sayı: 4

Kaynak Göster

Vancouver Uylaş U, Gündoğdu R. Is Pathological Assessment Necessary for Excised Sacrococcygeal Pilonidal Sinus Specimens?. Osmangazi Tıp Dergisi. 2021;43(4):403-6.


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