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Minimal incision as a promising technique for resection of pilonidal sinus in children
Chen Speter1, Osnat Zmora2, Roy Nadler1
1Department of Pediatric Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, 5265601, Israel.
Insights
Minimal incision surgery for pediatric pilonidal sinus offers better short-term recovery. This technique shows promising functional outcomes with comparable long-term results to wide excision.
Area of Science:
- Pediatric Surgery
- Surgical Techniques
- Pilonidal Sinus Disease
Background:
- Pilonidal sinus disease commonly affects children and adolescents.
- Surgical resection is the primary treatment for symptomatic pilonidal sinus.
- Traditional wide excision can lead to prolonged recovery.
Purpose of the Study:
- To compare the functional and long-term outcomes of minimal incision versus wide excision for pediatric pilonidal sinus resection.
- To evaluate the efficacy of a minimally invasive approach in children.
Main Methods:
- Retrospective chart review and follow-up telephone survey of pediatric patients.
- Comparison of demographic, clinical, and outcome data between minimal incision and wide excision groups.
- Level III therapeutic study.
Main Results:
- The minimal incision group (21 patients) experienced significantly fewer days on analgesics, fewer sick days, and faster return to full activity compared to the wide excision group (21 patients).
- Reoperation rates were 28% for minimal incision and 9% for wide excision (P=0.238).
- Favorable long-term outcomes were observed in 62% of the minimal incision group versus 45% in the wide excision group (P=0.354).
Conclusions:
- Minimal incision technique for pediatric pilonidal sinus resection is associated with superior postoperative functional recovery.
- This approach demonstrates comparable long-term outcomes to wide excision.
- Minimal incision surgery presents a promising alternative for managing pilonidal sinus in children.
Purpose:
To evaluate functional and long-term outcome of a minimal incision technique for resection of pilonidal sinus in children.
Patients And Methods:
All children who underwent surgery for pilonidal sinus in our institution between October 2008 and March 2015 were included. We performed a retrospective chart review and a follow-up telephone survey. Demographic, clinical and outcome data were compared between patients who underwent either minimal incision or wide excision surgery.
Results:
Study groups included 21 cases of minimal incision procedure and 21 cases of wide excision procedure with similar demographic and clinical characteristics. Postoperative functional outcome was significantly better in the minimal incision group with fewer days on analgesics (0 versus 2.5, P=0.005), fewer sick days (4 versus 14, P<0.001), and fewer days to full activity (10 versus 45, P<0.001). Reoperation rate was 28% for minimal incision and 9% for wide excision (P=0.238). Overall long-term favorable outcome (no reoperation/recurrent abscess/continued symptoms) rate was 62% after minimal incision and 45% after wide excision (P=0.354).
Conclusion:
The minimal incision is a promising technique for resection of pilonidal sinus in children as it is associated with better postoperative functional outcome and comparable long-term outcome compared with wide excision.
Level Of Evidence:
Therapeutic study- level III.
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