Recurrence Rates of Pilonidal Sinus Disease Are High in Children and Recurrences Occur Exceedingly Early

Abstract

Pilonidal sinus disease increasingly affects children and adolescents. While recurrence rates in adults are lower, with a minimum of 2% per year, and are essentially a function of the surgical approach over time, this is totally different in children. Many studies investigating children and adolescents report much higher recurrence rates. We aimed to gather and concentrate the available data on this matter in our review by searching PubMed, MEDLINE, and Scopus. The crude median recurrence rate of pilonidal sinus disease in children and adolescents was 13% (interquartile range, 7–20%) in our sample of 3599 patients in 42 studies, with a median study size of 52 (interquartile range, 27–96 patients) patients. Time to recurrence was available from eight studies with 1418 patients and its mean or median time to recurrence was usually much less than one year. For both parameters, an association with study size or patient age was not evident. Although treatment algorithms have been developed to adapt treatment to this dire situation, relevant improvements can only be expected if the underlying factors that cause these recurrence dynamics in children, which are substantially different from those in adults, were to be uncovered.