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Session:: ePosters-Sun800-M7: Benign Anorectal

EP310 - Modified Bascom II Procedure for Recurrent Sacrococcygeal Pilonidal Disease: A Single-Center, Large-Sample Clinical Outcomes Study

Sunday, May 10, 2026
9:00 AM - 9:05 AM ET

    ePoster Presenter(s)

  • ZHIYONG MAO

    Resident
    Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
    shanghai, Shanghai, China (People's Republic)

    Disclosure information not submitted.

    View ePoster

    • Author(s)

  • TONG SU, 在读状态 (she/her/hers)

    graduate student
    上海中医药大学附属龙华医院
    上海中医药大学附属龙华医院
    上海市, Shanghai, China (People's Republic)

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • YAN PAN, Master's degree

    Graduate Student
    Longhua Hospital Affiliated with Shanghai University of Traditional Chinese Medicine
    Shanghai University of Traditional Chinese Medicine
    SHANGHAI, Shanghai, China (People's Republic)

    Disclosure information not submitted.

  • QD

    QINGJUN DONG, Chief physician

    Deputy Director of the Department
    Anorectal surgery department, Longhua hospital of shanghai university of TCM
    shanghai, Shanghai, China (People's Republic)

    Disclosure information not submitted.

Purpose/Background: Background: Sacrococcygeal pilonidal disease (SPD) is an infectious condition occurring in the natal cleft. Currently, there is no "gold standard" surgical technique for SPD, and the choice between open and closed procedures remains controversial.

The Bascom II procedure has emerged as an effective treatment for SPD. However, the traditional Bascom II technique may still face challenges in complex cases, such as significant wound tension. To address these limitations, our team introduced modifications to the conventional procedure, including: (1) employing a bilateral flap technique when a unilateral flap is insufficient, particularly in patients with a history of multiple previous surgeries; (2) utilizing a three-layer suturing technique (sacral fascia, muscle, and skin layers) to minimize wound tension.

Objective: This study aimed to evaluate the clinical efficacy and postoperative outcomes of the modified Bascom II procedure in a large, single-center cohort.

Methods/Interventions:

Methods: This study included SPD patients who underwent either the modified Bascom II procedure or excision and lay-open technique between January 2020 and January 2025. The superiority of the modified Bascom II procedure was assessed by comparing the two groups in terms of healing rate, recurrence rate, wound healing time, complication rate, operative duration, length of hospital stay, and postoperative pain scores.

Results/Outcomes:

Results: A total of 84 patients are enrolled, comprising the modified Bascom II group (n=42) and the excision group (n=42). The majority of patients in both groups have a history of previous pilonidal surgery (66.7% vs. 64.3%, respectively). The baseline characteristics are comparable between the two groups. The modified Bascom II group demonstrates a significantly shorter wound healing time (40.1±18.3 vs. 60.2±14.5 days, p< 0.001), a dramatically lower recurrence rate (2.3% vs. 16.7%, p=0.025), and a lower complication rate (9.5% vs. 28.6%, p=0.032). Furthermore, the modified Bascom II procedure shows a trend towards higher healing rates and lower postoperative pain scores.

Conclusion/Discussion:

Conclusion: The modified Bascom II procedure is a safe and effective method for treating pilonidal disease. Compared to the excision technique, its advantages include: (1) minimal tissue excision, resulting in shorter healing time and less pain; (2) reduced wound tension via the three-layer closure, leading to lower postoperative complication rates; (3) etiological intervention by elevating the natal cleft, which significantly reduces recurrence rates.

Table 1. Clinical Efficacy Comparison of Modified Bascom II Procedures and Excision Procedures.
Figure 1. A 26-year-old male patient with SPD achieved complete recovery on the 44th day following treatment with the modified Bascom II procedure.