Department of Surgery, Sapienza University of Rome, Rome, Italy.
General Surgery Unit, Department of Medical and Surgical Sciences and Translational Medicine, St Andrea University Hospital, Sapienza University of Rome, Rome, Italy.
Colorectal Dis. 2023 Nov;25(11):2177-2186. doi: 10.1111/codi.16760. Epub 2023 Oct 4.
Pilonidal disease (PD) is a common debilitating condition frequently seen in surgical practice. Several available treatments carry different benefit/risk balances. The aim of this study was to snapshot the current management of PD across European countries.
Members affiliated to the European Society of Coloproctology were invited to join the survey. An invitation was extended to others via social media. The predictive power of respondents' and hospitals' demographics on the change of therapeutic approach was explored.
Respondents (n = 452) were mostly men (77%), aged 26-60 years, practising in both academic and public hospitals and with fair distribution between colorectal (51%) and general (48%) surgeons. A total of 331 (73%) respondents recommended surgery at first presentation of the disease. Up to 80% of them recommended antibiotic therapy and 95% did not use any classification of PD. A primary closure technique was the preferred procedure (29%), followed by open technique (22%), flap creation (7%), sinusectomy (7%) and marsupialization (7%). Approximately 27% of subjects would choose the same surgical technique even after a failure. Almost half (46%) perform surgery as office based. A conservative approach was negatively associated with acutely presenting PD (p < 0.001). Respondents who were not considering tailored surgery based on patient presentation tended to change their approach in the case of a failed procedure.
With the caveat of a heterogeneous number of respondents across countries, the results of our snapshot survey may inform the development of future guidelines.
藏毛窦病（PD）是一种常见的、经常在外科实践中出现的使人虚弱的疾病。现有的几种治疗方法具有不同的获益/风险平衡。本研究的目的是捕捉欧洲各国 PD 的当前治疗方法。
邀请欧洲结直肠外科学会成员参加调查。通过社交媒体向其他人员发出邀请。探索了受访者和医院的人口统计学特征对治疗方法变化的预测能力。
受访者（n=452）主要是 26-60 岁的男性（77%），在学术和公立医院工作，其中直肠结肠外科医生（51%）和普通外科医生（48%）的分布较为均衡。331 名（73%）受访者建议在疾病首次发作时进行手术。多达 80%的人建议使用抗生素治疗，95%的人不使用任何 PD 分类。首选的方法是一期缝合技术（29%），其次是开放式技术（22%）、皮瓣形成术（7%）、窦切除术（7%）和袋形切除术（7%）。约 27%的患者即使手术失败，也会选择相同的手术技术。近一半（46%）的人在办公室进行手术。保守治疗与急性 PD 呈负相关（p<0.001）。不考虑根据患者表现进行个体化手术的受访者，在手术失败的情况下，他们倾向于改变治疗方法。
尽管各国受访者的数量存在差异，但本快照调查的结果可能为未来指南的制定提供信息。
