Tsema Y. Low-traumatic methods of surgical treatment of the pilonidal cysts: justification and evaluation of the effectiveness

The author has conducted the complex analysis of the results of the diagnosis and treatment of 1 329 patients with pilonidal cysts. Patients were categorized into 3 clinicopathologic groups: the first group included 941 patients with acute pilonidal disease, the second group included 249 patients with chronic pilonidal disease, and the third group included 139 patients with relapse of pilonidal disease. The pathologic investigation of pilonidal cysts demonstrates the pilonidal disease has acquired origin; the mechanism of the etiopathogenesis has been shown. The author demonstrates etiopathogenesis of the pilonidal cyst, the staging of the course of pilonidal disease considering the nature of the disease, the succession of phases of its development, complications and outcomes. The superiority of the minimally invasive surgical treatment comparing with traditional methods of wide excision of the cyst based on the comparative analysis of the results of the pilonidal cyst treatment was shown. The author demonstrates that the ultrasonic dissection of the acute pilonidal abscess (the first stage) with the delayed ultrasonic debridement of the pilonidal cyst (the second stage) is the optimal method of the surgical treatment of the acute pilonidal disease. The author shows that in patients with the chronic pilonidal disease the best results has the ultrasonic dissection of the cyst, and in patients with the relapse of the pilonidal disease the most effective method is ultrasonic debridement of the relapsed pilonidal cyst.