Cost effectiveness of routine pathological evaluation in sacrococcygeal pilonidal sinus specimens

Abstract

Pilonidal sinus is a benign pathology that occurs especially in the sacrococcygeal region. Routine specimen examination is controversial because malignancy is very rare in histopathological examination. In this study, we aimed to discuss the pathological findings of patients who were operated for sacrococcygeal pilonidal sinus in our clinic in the light of the literature. Between May 2019 and December 2022, 257 patients who were operated on with the diagnosis of pilonidal sinus at the Samsun Training and Research Hospital General Surgery Clinic were retrospectively analyzed and included in the study. In the histopathological examination, it was reported that pilonidal sinus was found in 115 patients, chronic active inflammation in 79 patients, foreign body type inflammatory event in 60 patients, epidermal cyst in 1 patient, fibrolipoma in 1 patient, and Hidraadenitis Supurativa in 1 patient. In some recent studies, histopathological examination should be performed in patients over 50 years of age. Malignant pathology is mostly seen in males and. squamous cell carcinoma was seen in 76 of these patients and epidermoid carcinoma, basal cell carcinoma and malignant degeneration were seen in the others. Although our average age is low, our male / female ratio was found close to the literature. None of our pathology results were malignant. Pathologic examination of specimens removed in operation requires a certain workload and cost. We think that pathological examination is not required in every patient and that it is more effective in terms of both cost and workload to select the patients to be examined according to characteristics such as advanced age, chronic inflammation, suspicion of macroscopic malignancy and recurrent disease.

Keywords

• pilonidal sinus
• cost effectivity
• clinical pathology
• pathology

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