Department of Surgery, Stanford University, 453 Quarry Road, Palo Alto, CA, 94304, USA.
Pediatr Surg Int. 2023 Oct 31;39(1):285. doi: 10.1007/s00383-023-05577-w.
Patients with mild pilonidal disease often experience symptom resolution without excision. We hypothesized that treating symptom-free/asymptomatic pilonidal patients with regular epilation alone had similar recurrence rate as patients who were also treated surgically.
Patient data were prospectively collected 2/2019-11/2022 at our Pilonidal Clinic. All patients received regular epilation; all patients presented before 12/2020 also underwent pit excision using trephines. Starting 1/2021, only symptomatic patients underwent pit excision; symptom-free patients at presentation received only regular epilation. Recurrence rates were statistically analyzed.
255 patients (male:54.4%, female:45.6%), median age 17.3years (IQR:15.8-19.1) were followed for median 612.5days (IQR:367.5-847). 44.1% identified as Hispanic, 36.5% Caucasian, 17.1% Asian, 2.4% Black. Median symptom duration at presentation was 180.5days (IQR:44.5-542.5). 160 patients were initially treated with surgical excision and regular epilation, while 95 patients with regular epilation only. The failure rate between patients who received surgical excision initially and recurred (9.4%) and patients who received epilation only and recurred (12.6%) was similar, after controlling for sex, race, age, comorbidities, skin type, hair color, hair thickness (p > 0.05). Patients who recurred after only undergoing regular epilation all underwent surgical excision, median 100days (IQR:59.5-123.5) after initial presentation.
Regular epilation alone is an acceptable treatment for symptom-free pilonidal patients.
患有轻度藏毛疾病的患者通常无需切除即可缓解症状。我们假设，仅对无症状/无明显症状的藏毛疾病患者进行常规除毛治疗，其复发率与接受手术治疗的患者相似。
患者数据于 2019 年 2 月至 2022 年 11 月在我们的藏毛疾病诊所前瞻性收集。所有患者均接受常规除毛；所有于 2020 年 12 月前就诊的患者均采用环钻进行藏毛窦切除。自 2021 年 1 月起，仅对有症状的患者进行藏毛窦切除；就诊时无症状的患者仅接受常规除毛。对复发率进行了统计学分析。
255 例患者（男性占 54.4%，女性占 45.6%），中位年龄 17.3 岁（IQR：15.8-19.1），中位随访时间为 612.5 天（IQR：367.5-847）。44.1%的患者为西班牙裔，36.5%为白种人，17.1%为亚洲人，2.4%为黑人。就诊时的中位症状持续时间为 180.5 天（IQR：44.5-542.5）。160 例患者最初接受手术切除和常规除毛治疗，95 例患者仅接受常规除毛治疗。在控制性别、种族、年龄、合并症、皮肤类型、头发颜色、头发厚度后，最初接受手术切除且复发（9.4%）的患者与仅接受除毛治疗且复发（12.6%）的患者的失败率相似（p＞0.05）。仅接受常规除毛治疗后复发的患者均接受了手术切除，中位时间为初始就诊后 100 天（IQR：59.5-123.5）。
仅常规除毛治疗是无症状藏毛疾病患者的一种可接受的治疗方法。
