Triangle Excision and Advancement Flap in Pilonidal Disease: A Single-Center Prospective Case Series

Aim: Pilonidal disease (PD) is frequently encountered within the community. There are still ongoing debates regarding its treatment in general surgery clinics. Although minimally invasive methods such as phenol, laser ablation, and endoscopic pilonidal sinus treatment are gaining prominence, flap applications remain the preferred option in patients where these methods fail or the disease is widespread. In this study, we describe the clinical outcomes of patients operated on using the triangle excision and advancement flap technique, which allows for the removal of less tissue near the perianal region. Method: Prospectively collected data were retrospectively analyzed. Age, gender, body mass index (BMI), disease duration, hirsutism score, number of pits, complications, operation time, hospitalization period, and postoperative 3-, 6-, and 9-month follow-up results of the patients were analyzed. The results of the analysis showed that no complications or recurrences were observed in any patient. Results: A total of 46 patients were included in this study. The mean age of the patients was 23.69 (±7.06). Of the 46 patients, 41 were men (89.1%), and 5 were women (10.9%). The mean age of the men was 23.3 (±7.33), and the mean age of the women was 26.6 (±3.5). In terms of hirsutism score, 34 patients (73%) had a score of 2, and 12 patients (27%) had a score of 3. The mean BMI was 23 (±2.16). All patients were operated on under spinal anesthesia. The mean operation time was 40 (±7.55) minutes, and the mean hospitalization time was 1 (±0) day. In terms of early complications, flap dehiscence was observed in 2 patients. Of these, one was a patient for whom a surgical drain was not placed. No bleeding was detected in any patient, and urinary retention was observed in 3 patients. Conclusion: We believe that the triangle excision and advancement flap method can be safely employed in PD.