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Minimally invasive treatment of pilonidal sinus disease in a paediatric population: comparison of two techniques
Sara Fernandes1, Carolina Soares-Aquino1, Inês Teixeira1
1Department of Paediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal.
Background:
Pilonidal disease (PD) is a common and debilitating inflammatory condition with significant impact on quality of life. Minimally invasive techniques (MIT) have shown promising results comparing to traditional excision. Herein we present a comparison of two MIT techniques -sinusectomy (SE) and pit-picking plus laser ablation (PPL).
Methods:
All cases of paediatric PD treated by PPL and SE at our center between August 2018 and August 2020 were retrospectively reviewed.
Results:
One-hundred and six patients were included, with a median age of 16 years (IQR 15-16). PPL was the procedure of choice in 36 patients (34%) and the remaining underwent SE (66%). Median healing time was significantly lower in SE group (20 days), comparing to PPL (30 days) (p = 0.002). Early healing failure occurred more frequently in the PPL group (p = 0.003). Recurrence rate was similar between groups - PPL 17% versus SE 16% (p = 0.89). Overall complication rate was 9% and was significantly higher in PPL (p = 0.03).
Conclusions:
MIT techniques are promising solutions in PD treatment. Although similarly easy and fast to perform, SE technique showed better healing profile and lower complication rate but no significant difference on recurrence rates was observed.
Insights
Minimally invasive techniques (MIT) for pilonidal disease (PD) show promise. Sinusectomy (SE) demonstrated faster healing and fewer complications than pit-picking plus laser ablation (PPL), with similar recurrence rates.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Pilonidal disease management
Background:
- Pilonidal disease (PD) is a common, debilitating inflammatory condition impacting quality of life.
- Minimally invasive techniques (MIT) offer potential advantages over traditional excision for PD treatment.
Purpose of the Study:
- To compare the efficacy and outcomes of two MIT for pediatric PD: sinusectomy (SE) and pit-picking plus laser ablation (PPL).
Main Methods:
- Retrospective review of pediatric PD cases treated with PPL or SE between August 2018 and August 2020.
- Analysis of healing time, healing failure, recurrence rates, and complication rates.
Main Results:
- Sinusectomy (SE) showed a significantly lower median healing time (20 days) compared to pit-picking plus laser ablation (PPL) (30 days).
- PPL had a higher rate of early healing failure and a significantly higher overall complication rate.
- Recurrence rates were similar between SE (16%) and PPL (17%).
Conclusions:
- While both MIT are viable for pediatric PD, SE offers a better healing profile and lower complication rate.
- No significant difference in recurrence rates was observed between SE and PPL.
