Background: Minimally invasive procedures have increasingly been used to treat pilonidal disease; however, the mid-term and long-term results have not been evaluated extensively yet.
Patients and methods: All patients underwent "pit picking" surgery. The surgery was performed under local anesthesia. The technique of "pit picking" was: all midline pits were removed by excising a margin of skin of < 1 mm. An incision of 1 cm parallel to one side of the natal cleft opened the chronic abscess cavity. No specific postoperative wound care was given.
Results: A total of 153 patients (126 males) underwent "pit picking" surgery between June 2007 and November 2010. Follow-up information was available for 148 patients (97 %). Of the patients 74% had no recurrence after a median follow-up time of 30 months and 8 more patients (5 %) remained asymptomatic after a second"pit picking" procedure. By multivariate analysis, smoking (hazard ratio [HR] 2.1) and occurrence of an abscess during the course of disease (HR 2.7) were statistically significantly associated with the disease recurrence after "pit picking" surgery.
Conclusion: Approximately three quarters of selected patients with pilonidal disease benefit from minimally invasive "pit picking" surgery.