title: Minimally invasive surgery for the treatment of pilonidal disease. The Gips procedure on 2347 patients.
abstract: BACKGROUND
  Pilonidal disease is a quite common chronic inflammatory disease that causes discomfort, embarrassment and absence from work or school. In line with its acquired pathogenesis, a number of surgical alternatives to conventional en bloc excision have been proposed over the last decades, yielding encouraging results. We reviewed our experience with minimally invasive sinusectomy to evaluate its safety and efficacy.
  
  
  METHODS
  this study was a review of a prospectively maintained database of consecutive patients over a 7-year period. From November 2009 to December 2015, 2347 patients with pilonidal disease were operated on using the Gips procedure. Patients received surgery as a day-case procedure under local anesthesia. Operative and perioperative data were examined.
  
  
  RESULTS
  there were 1714 men (73%) and 633 women (27%) in the study; the median age was 19 years. Recurrent diseases in patients who had previously undergone surgery elsewhere composed 61% of cases. Globally, 102 cases of clinically relevant postoperative complication occurred (4.3%). At a median follow up of 16 months, the recurrence rate was 5.8%. The treatment of recurrent disease did not correlate to increased recurrence rate following sinusectomy. Recurrent patients were more likely to be male and have delayed wound healing.
  
  
  CONCLUSIONS
  the Gips procedure for the treatment of pilonidal disease is safe and feasible. It has a low complication and recurrence rate, early return to daily activities and offers a good cosmetic result.
authors.affiliation: Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Castro
authors.affiliation: Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy. Electronic address: fra.guerra.mail@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerra
authors.affiliation: Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Levi Sandri
authors.affiliation: Division of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010864:Pilonidal Sinus / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Minimally invasive surgery; Pilonidal disease; Trephines