Is Histopathological Examination Necessary After Sacrococcygeal Pilonidal Sinus Excision?

A pilonidal sinus is a common disease that usually occurs in the natal cleft in the sacrococcygeal region. Many conservative and surgical treatment methods are available. Malignancy is rarely detected; therefore, a routine histopathological examination is controversial. This study aimed to evaluate the pathology results of patients who underwent sacrococcygeal pilonidal sinus excision in our clinic. The records of patients who underwent pilonidal sinus excision at Istanbul Sultanbeyli State Hospital between January 2016 and October 2021 were reviewed retrospectively. The following parameters were evaluated: age, gender, location of disease, and histopathological examination outcome. During the study period, 2,091 patients underwent surgery for pilonidal sinus disease at our general surgery clinic. The data of 2,068 patients were analyzed after excluding 23 patients who underwent excision for disease outside the sacrococcygeal region or had missing data. The age of the patients ranged from 13 to 72, with a female-to-male ratio of 535:1533. The mean age was 24.7±8.2 years. Pilonidal sinus specimen pathologies excised from the sacrococcygeal region were examined, and no malignancies were detected. Routine histopathological examination of pilonidal sinus specimens may be unnecessary if there are no risk factors such as atypical presentation and appearance, relapse, long-term disease, and advanced age.