Pediatric pilonidal sinus disease: Recurrence rates of different age groups compared to adults.

Background: Pilonidal sinus disease uncommon in pre-pubertal children. The preferred treatment for pediatric pilonidal sinus patients remains unclear. A growing body of evidence indicates that pediatric pilonidal sinus disease recurs earlier than in adults. We therefore aimed to investigate recurrence rates and the recurrence rates of different surgical approaches.

Methods: Some 1217 studies on pilonidal sinus disease, encompassing 134,663 patients were eligible. From them, 5807 pediatric patients were identified. Recurrence rates were compared between adults and children.

Results: Pediatric pilonidal sinus patients have a higher 5-year recurrence rate compared to adults (46 % vs. 11.5 %;  < 0.0001). The subgroup of individuals aged 16-18 years appears to experience recurrences 12 months earlier than those below the age of 16. 46.4 % of all pediatric recurrences occur within 5 years.

Conclusions: Pediatric pilonidal sinus disease seems to follow a different course in terms of recurrence rate compared to adults with a substantially increased probability of developing recurrent pilonidal sinus disease within the first five years after surgery. Due to the limited evidence base, especially in terms of the surgical approach, additional data is required to gain a more detailed insight into the matter and to improve surgical care for children and adolescents.