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Published on: June 20, 2018
Initial experience with minimally invasive treatment of pilonidal sinus in children
Vojtech Dotlacil1, Michal Rygl1, Barbora Frybova1
1Department of Paediatric Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
Insights
Minimally invasive endoscopic treatment of pilonidal sinus (PEPSiT) shows promise for pediatric patients, offering a safe and well-tolerated option with quick recovery and low pain. Two recurrences were successfully managed with repeat PEPSiT procedures.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Procedures
- Inflammatory Diseases
Background:
- Sinus pilonidalis (SP) is a common acquired inflammatory condition in children.
- Surgical intervention is typically required for symptomatic cases.
- Minimally invasive pilonidal sinus treatment (EPSiT) was adapted for pediatric use in 2017.
Purpose of the Study:
- To assess the initial clinical experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT) in the Czech Republic.
- To evaluate the safety and efficacy of PEPSiT in a pediatric and adolescent cohort.
- To analyze perioperative outcomes, complications, and recurrence rates associated with PEPSiT.
Main Methods:
- Retrospective analysis of pediatric patients undergoing PEPSiT between November 2018 and February 2020.
- Data collection included demographics, surgical details, hospital stay, complications, healing, and recurrence.
- Patient-reported pain was assessed using the Visual Analog Scale (VAS).
Main Results:
- Seventeen pediatric patients (median age 17.1 years, 76% male) were included.
- The median PEPSiT duration was 50 minutes, with no postoperative complications reported within 30 days.
- Fourteen of fifteen patients achieved healing, with two recurrences successfully treated by re-PEPSiT.
Conclusions:
- PEPSiT is a highly promising, safe, and well-tolerated treatment for pediatric sinus pilonidalis.
- The procedure facilitates a short hospital stay and rapid return to normal activities with minimal pain.
- Repeat PEPSiT (re-PEPSiT) is an effective option for managing disease recurrence.
Introduction:
Sinus pilonidalis (SP) is an acquired inflammatory disease, which is relatively common in the paediatric population. Surgery is indicated in symptomatic patients. In 2017, minimally invasive pilonidal sinus treatment (EPSiT) was adapted to the paediatric population.
Aim:
To evaluate the first experience with minimally invasive endoscopic treatment of SP (PEPSiT) in children and adolescents in the Czech Republic.
Material And Methods:
A retrospective review of all consecutive paediatric patients who underwent PEPSiT from November 2018 to February 2020. The monitored parameters were demographics, perioperative course of the disease, surgery, length of hospitalisation, postoperative complications, healing, disease recurrence, and follow-up.
Results:
Seventeen patients were enrolled in the study. The median age at surgery was 17.1 years (range: 12.5-18). The subjects comprised 76% males, and the median body mass index was 25.6 kg/m2 (range: 17-30.3 kg/m2). Thirteen patients underwent previous surgical treatment (76%) under local anaesthesia. The median duration of PEPSiT was 50 min (range: 30-85 min). The subjective evaluation of pain by patients on the VAS scale was 0 on the day of discharge. There were no postoperative complications up to the 30th postoperative day. Two disease recurrences were successfully managed by re-PEPSiT. By the end of follow-up, 14/15 patients had healed. Two patients are still within 3 months of surgery, which is too soon to definitively evaluate possible recurrence of the disease.
Conclusions:
These preliminary results show that PEPSiT is a highly promising method. It is safe and well-tolerated by patients (short hospital stay, quick return to normal life, low pain and analgesic consumption). Two recurrences of disease were treated by re-PEPSiT.
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