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Endoscopic pilonidal sinus treatment versus total excision with primary closure for sacrococcygeal pilonidal sinus

Joana Barbosa Sequeira1, Ana Coelho1, Ana Sofia Marinho1

  • 1Department of Pediatric Surgery, Centro Materno Infantil do Norte, Centro Hospitalar do Porto, Porto, Portugal.

Journal of Pediatric Surgery
|April 1, 2018
PubMed

Insights

Endoscopic Pilonidal Sinus Treatment (EPSiT) is a safe and effective alternative to traditional excision for pediatric sacrococcygeal pilonidal sinus. This study found EPSiT comparable to excision with primary closure in outcomes.

Area of Science:

  • Pediatric surgery
  • Minimally invasive surgical techniques
  • Pilonidal sinus disease management

Background:

  • Pilonidal sinus disease (PSD) is a common condition affecting adolescents and young adults.
  • Traditional surgical management often involves excision with primary closure (EPC), which can lead to significant morbidity.
  • Endoscopic Pilonidal Sinus Treatment (EPSiT) offers a minimally invasive approach.

Purpose of the Study:

  • To evaluate the effectiveness and safety of EPSiT in pediatric patients with sacrococcygeal pilonidal sinus.
  • To compare EPSiT with EPC regarding intraoperative and postoperative outcomes in this population.

Main Methods:

  • Retrospective analysis of pediatric patients with chronic sacrococcygeal pilonidal sinus treated with EPSiT or EPC over 12 months.
  • Comparison of demographic data and surgical outcomes between the two treatment groups.
  • Therapeutic study, level of evidence III.

Main Results:

  • A total of 21 EPSiT cases and 63 EPC cases were analyzed, with similar demographics.
  • Operative time and healing time were comparable between EPSiT and EPC.
  • EPSiT showed a lower wound infection rate (5.2% vs. 20.0%) and a trend towards lower recurrence rates (10.5% vs. 21.6%), though not statistically significant (p>0.05).

Conclusions:

  • EPSiT is a viable and safe treatment option for sacrococcygeal pilonidal sinus in the pediatric population.
  • The study suggests EPSiT is comparable to EPC in terms of overall outcomes, with potential benefits in reduced infection rates.
Abstract

Keywords:
ChildrenEndoscopyMinimally invasive surgeryPilonidal sinus

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