The clinical presentation of pilonidal sinus and selection of the appropriate minimally invasive approach. A retrospective evaluation of 5338 cases.

Objective: Pilonidal Sinus is a considerably problematic disease due to its recurrences which tend to become chronic and are exacerbated by abscess formation. There is little consensus regarding treatment - most probably due to limited understanding of its pathophysiology and progression. Despite this, it is accepted that accurate identification of pathogenesis and the clinical grade of PS are crucial for the determination of surgical approach.

Method: This study presents the surgical treatment techniques we employed for Pilonidal Sinus disease with retrospective analysis of management and follow-up data of 5338 outpatient cases from 16 years of practice.

Results: At the follow-up period of 16 years, recurrence was 12.5%. All recurrences were also treated with an individualized minimally invasive surgical approach, which was proportional to the clinical presentation.

Conclusion: The importance of designing surgical technique according to the needs of the patient and the condition of the disease is clear. Our results with over 5000 patients indicate that effective treatment for PS is individualized minimally invasive surgery.

Key Words: Classification, Grade, Minimally invasive surgery, Pilonidal sinus, Pilonidal cyst.