Abstract:

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.