IS HISTOPATHOLOGICAL EXAMINATION OF EXCISION MATERIAL IN PILONIDAL SINUS SURGERIES A WASTE OF COST, TIME AND LABOR?
Abstract
INTRODUCTION
Pilonidal sinus (PS) surgery is one of the most common operations performed in general surgery. Although different treatments are used nowadays, the main treatment of the disease is still surgical excision. Malignant degeneration is very low in patients with chronic pilonidal sinus.Cases have been reported in the literature as case reports. In this study, we aimed to reveal the necessity of routine histopathological examination of the excision material in PS surgery.
MATERIAL & METHODS
We have considered patients in our hospital database, who had pilonidal sinus surgery with a diagnosis of PS retrospectively. 939 patients , whose histopathological examination reports of PS excision specimen were accessed , were included in the study.
RESULTS
Of the 939 patients included in the study, 721 of which (76.8%) are male and 218 of which (23.2%) are female. The mean age of the patients is 25.6 ± 7.4 (min- max :59) years. The number of patients over 50 years was 24 (2.6%). The number of patients operated with recurrent pilonidal sinus was 26 (2.8%). No malignancy was observed in any of the histopathological examinations of 939 excision materials.
CONCLUSION
No malignancy has been detected in any of our PS cases in the histopathological examination. The necessity of routine histopathological examination of PS excision materials should be questioned and discussed. It causes both a waste of time and money. However, it can be considered for the patients over 50, since the literature shows an increase in risk of malignancy after this age.
Project Number
YOK
References
- References 1-Kuckelman JP. Pilonidal disease: Management and definitive treatment. Dis Colon Rectum. 2018;61:775-77.
- 2-Johnson EK, Vogel JD, Cowan ML, Feingold DL, Steele SR; Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 2019:62:146-57.
- 3-Parpoudi SN, Kyziridis DS, Patridas DC, Makrantonakis AN, Iosifidis P, Mantzoros IG, et al. Is histological examination necessary when excising a pilonidal cyst? Am J Case Rep. 2015;21:164-8.
- 4 Sondenaa K, Andersen E, Nesvik I, Soreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995;10:39-42.
- 5-Parades V, Bouchard D, Janier M, Berger A. Pilonidal sinus disease. J Visc Surg. 2013;150:237-47.
- 6-Delvecchio A, Laforgia R, Sederino MG, Minafra M, Carbotta G, Balducci G, et al. Squamous carcinoma in pilonidalis sinus: Case report and review of literature. G Chir. 2019;40:70-4.
- 7-Humphries AE, Duncan JE. Evaluation and management of pilonidal disease. Surg Clin North Am. 2010;90:113-24.
- 8-Borges VF, Keating JT, Nasser IA, Cooley TP, Greenberg HL, Dezube BJ. Clinicopathologic characterization of squamous-cell carcinoma arising from pilonidal disease in association with condylomata acuminatum in HIV infected patients. Dis Colon Rectum. 2001;44:1873-7.
- 9-Abboud B, Ingea H. Recurrent squamous-cell carcinoma arising in sacrococcygeal pilonidal sinus tract. Dis Colon Rectum. 1999;42:525-8
- 10-Tirone A, Gaggelli I, Francioli N, Venezia D, Vuolo G. Degenerazione maligna di una cisti pilonidale. Ann Ital Chir. 2009; 80:407-9.
- 11-Boulanger G, Abet E, Brau-Weber AG, Leclair F, Denimal F, Jean MH, et al. Is histological analysis of pilonidal sinus useful? Retrospective analysis of 731 resections. J Visc Surg. 2018;155:191-94.
- 12-De Bree E, Zoetmulder FA, Christodoulakis M, Aleman BM, Tsiftsis DD. Treatment of malignancy arising in pilonidal disease. Ann Surg Oncol. 2001;8:60-4.
- 13-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.
- 14-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.
- 15-Velitchklov N, Vezdarova M, Losanoff J, Kjossev K, Katrov E. A fatal case of carcinoma arising from a pilonidal sinus tract. Ulster Med J. 2001;70:61-3.
Pilonidal Sinüs Sinüs Ameliyatlarında Eksizyon Materyalinin Histopatolojik İncelemesi Maliyet, Zaman ve İş Gücü Kaybı Mı?
Abstract
GİRİŞ
Pilonidal sinüs (PS) genel cerrahide en çok yapılan ameliyatlardan birisidir. Günümüzde farklı tedaviler kullanılmakla birlikte hastalığın başlıca tedavisi hala cerrahi eksizyondur. Kronik pilonidal sinüsü olan hastalarda malign dejenerasyonu oldukça düşüktür.Literatürde olgu sunumu şeklinde vakalar bildirilmiştir. Bu çalışmada, PS cerrahisinde , eksizyon materyalinin rutin olarak yapılan histopatolojik incelemesinin gerekliliğini ortaya koymayı amaçladık.
YÖNTEM
Hastanemiz veri tabanında kayıtlı PS tanısıyla pilonidal sinüs eksizyonu yapılan hastalar retrospektif olarak değerlendirildi. Pilonidal sinüs eksizyonu piyesinin histopatolojik inceleme raporlarına ulaşılan 939 hasta çalışmaya dahil edildi.
BULGULAR
Çalışmaya dahil edilen 939 PS hastasının 721'i (%76.8) erkek, 218'i (%23.2) kadındı. Hastaların yaş ortalaması 25.6 ± 7.4 (min = 18 ve maks = 59.0) yıldı. 50 yaş üstü hasta sayısı 24 (%2.6) idi. Nüks pilonidal sinüs tanısı ile ameliyat edilenlerin sayısı 26 (%2.8) olarak belirlendi . 939 hastanın eksizyon materyallerinin histopatolojik incelemesinin hiçbirinde malignite görülmedi.
SONUÇ
Histopatolojik inceleme yapılan hiçbir PS vakamızda maligniteye rastlanmadı. PS ekizyon materyallerinin histopatolojik incelemesinin rutin olarak yapılmasının gerekliliği sorgulanmalı ve tartışılmaalıdır. Maliyet ve zaman açısından kayba neden olmaktadır. Ancak literatürde tariflenen şüpheli ve malignite riski artması sebebi ile 50 yaş üstü hastalarda düşünülebilir.
Supporting Institution
YOK
Project Number
YOK
Thanks
YOK
References
- References 1-Kuckelman JP. Pilonidal disease: Management and definitive treatment. Dis Colon Rectum. 2018;61:775-77.
- 2-Johnson EK, Vogel JD, Cowan ML, Feingold DL, Steele SR; Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 2019:62:146-57.
- 3-Parpoudi SN, Kyziridis DS, Patridas DC, Makrantonakis AN, Iosifidis P, Mantzoros IG, et al. Is histological examination necessary when excising a pilonidal cyst? Am J Case Rep. 2015;21:164-8.
- 4 Sondenaa K, Andersen E, Nesvik I, Soreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995;10:39-42.
- 5-Parades V, Bouchard D, Janier M, Berger A. Pilonidal sinus disease. J Visc Surg. 2013;150:237-47.
- 6-Delvecchio A, Laforgia R, Sederino MG, Minafra M, Carbotta G, Balducci G, et al. Squamous carcinoma in pilonidalis sinus: Case report and review of literature. G Chir. 2019;40:70-4.
- 7-Humphries AE, Duncan JE. Evaluation and management of pilonidal disease. Surg Clin North Am. 2010;90:113-24.
- 8-Borges VF, Keating JT, Nasser IA, Cooley TP, Greenberg HL, Dezube BJ. Clinicopathologic characterization of squamous-cell carcinoma arising from pilonidal disease in association with condylomata acuminatum in HIV infected patients. Dis Colon Rectum. 2001;44:1873-7.
- 9-Abboud B, Ingea H. Recurrent squamous-cell carcinoma arising in sacrococcygeal pilonidal sinus tract. Dis Colon Rectum. 1999;42:525-8
- 10-Tirone A, Gaggelli I, Francioli N, Venezia D, Vuolo G. Degenerazione maligna di una cisti pilonidale. Ann Ital Chir. 2009; 80:407-9.
- 11-Boulanger G, Abet E, Brau-Weber AG, Leclair F, Denimal F, Jean MH, et al. Is histological analysis of pilonidal sinus useful? Retrospective analysis of 731 resections. J Visc Surg. 2018;155:191-94.
- 12-De Bree E, Zoetmulder FA, Christodoulakis M, Aleman BM, Tsiftsis DD. Treatment of malignancy arising in pilonidal disease. Ann Surg Oncol. 2001;8:60-4.
- 13-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.
- 14-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.
- 15-Velitchklov N, Vezdarova M, Losanoff J, Kjossev K, Katrov E. A fatal case of carcinoma arising from a pilonidal sinus tract. Ulster Med J. 2001;70:61-3.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Project Number | YOK |
| Publication Date | December 25, 2023 |
| Submission Date | May 16, 2023 |
| Published in Issue | Year 2023 Volume: 2 Issue: 4 |
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