Endoscopic pilonidal sinus treatment (EPSiT) in the pediatric age group: short-term results

• Published in: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES 2021-07, Vol.27 (4), p.443-448
• Main Author: Gokbuget, Zeynep Merve
• Format: Article
• Language: English
• Subjects: Age groups; Endoscopy; Pediatrics; Sinuses; Wound healing
• ISSN: 1306-696X; 1307-7945
• DOI: 10.14744/tjtes.2020.74677

BACKGROUND: This study aims to evaluate the short term outcomes of the Endoscopic pilonidal sinus treatment (EPSiT) in the pediatric age group. METHODS: In this study, between June 2018 and July 2019, pediatric patients with pilonidal sinus (PS) who were treated with the EPSiT method were reviewed retrospectively. RESULTS: Of the twenty-nine patients (20 males, nine females), the average age was 15.5±2.8 years, and the average body mass index (BMI) was 25.8±4.2. Eight patients (28%) presented with a history of recurrence following the previous surgery. The average number of fistulas present in cases was 1.17 (1–2). The localization of the fistula was midline in twenty-four and lateral in five of the patients. The average time of the EPSiT procedure was 57±13.9 minutes, and the average time of hospital stay was 11.4±7.2 hours. The pain score average was 0.86 (range of 0–3) and the duration of analgesic use was 37 hr (12–72 hr). The mean post-operative time of total wound healing was 18.71 days (7–60 days) for primary presenting cases. Early wound healing was seen in twenty-five patients (average of 14 days), while late wound healing was observed in four patients (average of 60 days). The mean time of follow-up was 8.3±3.34 months. The average time of return to full daily activity was 2.1 days (0–30 days), while it was the same day for sixteen (53%) patients. In post-operative follow-up, early (bleeding: 1) and late (formation of granulation tissue: 1, recurrence: 8) complications were seen in nine patients. Of the eight patients (27.5%) whose recurrence was detected, seven were primary and one was secondary presenting patients. The average time of presentation for recurrence was 5.8 mo (1–10 mo). Re-EPSiT was applied in two of the eight patients with recurrence and is planned for five, while one of the patients lost to follow-up. CONCLUSION: EPSiT is an easily applicable, pain-free minimal invasive procedure with a short period of hospital stay and a fast return to routine daily activity. It provides comfortable and repeatable intervention in cases with recurrences after the EPSiT procedure and other methods for PS treatment.