Is Pathological Assessment Necessary for Excised Sacrococcygeal Pilonidal Sinus Specimens?

Öz

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.

Anahtar Kelimeler

• Pilonidal sinus
• carcinoma
• pathology
• squamous cell carcinoma
• phenol

Sakrokoksigeal Pilonidal Sinüs Spesmenlerinde Patolojik Değerlendirme Gerekli midir?

Öz

Pilonidal sinüsün bazı cerrahi yöntemlerinde hastada sakrokoksigeal pilonidal sinüs boşluğu kalmaktadır ve bu durum bizi patolojik incelemenin gerekliliğini sorgulamaya yöneltmiştir. Ocak 2016-Mart 2020 tarihleri arasında Gaziantep Dr. Ersin Arslan Eğitim ve Araştırma Hastanesi'nde sakrokoksigeal pilonidal sinüs için cerrahi eksizyon uygulanan hastalar retrospektif olarak tarandı. Sakrokoksigeal bölge dışındaki pilonidal sinüsü olan hastalar, minimal invaziv tedavi gören ve histopatolojik incelemesi olmayan hastalar çalışma dışı bırakıldı. Hastaların cinsiyeti, yaşı, ameliyat notları ve patoloji sonuçları analiz edildi. Tüm hastalara eksizyon artı flep (Limberg veya Karydakis) prosedürü uygulandı ve spesmenler rutin histopatolojik incelemeye gönderildi. Sakrokoksigeal pilonidal sinüs nedeniyle ameliyat edilen 1971 hastanın 1551'I (% 79) erkek, 420'si (% 21) kadındı ve yaş ortalaması 24 (13-66) idi. Patolojik bulguların hiçbiri malignite göstermedi. Literatürde bildirilen malignite oranı, patoloji örneklerinin alınmadığı minimal invaziv prosedürlerle uyumlu değildir. Uzun süreli hastalık, yaşlılık, makroskopik şüphe veya nüks durumları dışında pilonidal sinüsün rutin patolojik incelemesinin gereksiz olabileceğine inanıyoruz.

Anahtar Kelimeler

• Pilonidal sinüs
• karsinom
• patoloji
• skuamöz hücreli karsinom

Kaynakça

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