Minimally Invasive Closed Excision of pilonidal cyst (MICE): Results of a series of 145 consecutive patients
Minimally Invasive Closed Excision of pilonidal cyst
Wound healing is the main drawback of pilonidal disease surgery. Many surgical techniques have been reported to challenge the excision and lay-open techniques which remain popular despite long healing times and debilitating condition. Herein is reported the results of a minimally invasive closed excision (MICE) that meets the gold principles of the wide excision lay-open technique without it’s side effects.
MICE consisted of wide excision of postsacral diseased tissue through a minimal access using a thermofusion device. Then hair containing sinuses and pits including dermal abscesses were excised by cold bistoury. Wounds were covered with a pressure-dressing until day 4, then patients wore a pair of compression-shorts (Medical Innovation Care Europe, Avignon, France) until day 10 or until healed. Results were collected prospectively. Phone surveys were carried out among patients having 6 months of follow up at minimum. The first endpoints were healing time and recurrence.
MICE was carried out in 145 consecutive outpatients. Two patients were converted to lay-open technique and excluded from the survey. 130 patients were followed up for a minimum of 6 months (6 to 68). The recurrence rate was 7% (9/130) over a median follow up of 30 months. A 90% healing rate was achieved by postoperative week 3. The median healing time was 15 days.
Minimally invasive closed excision of pilonidal disease (MICE) was applied to consecutive patients. It applied well to an extensive disease. This technique achieved complete excision of pilonidal disease, had a median healing time of 15 days and a low recurrence rate of 7%. These results advocate MICE as the gold standard for pilonidal excision.