Endoscopic Treatment of Pilonidal Sinus Disease in Children: A Systematic Review

Pilonidal sinus disease (PSD) is a common inflammatory disease. PSD management in pediatric patients changed dramatically in the last few years especially when concerning the latest minimally invasive techniques. This article aims to identify clinical evidence about the reliability of the different techniques in managing PSD in children. We performed a PubMed search for articles published during the last 10 years, using the keywords "pilonidal," "sinus," "disease," "pediatric," "surgery," and "children." We pooled 38 studies, 18 of these were excluded because they were either not relevant or concerned an adult population. Literature analysis shows that endoscopic techniques for PSD are superior to excision and primary closure (EPC) in terms of tolerance and postoperative conditions and, with the growing number of studies in the matter, important endpoints such as wound healing time and length of hospital stay will be proved to be superior. Pediatric Endoscopic pilonidal disease treatment showed to be a very promising alternative even from a statistical point of view, especially when considered that in this group, studies seemed to be more solid. Literature analysis showed that minimally invasive techniques were statistically superior to EPC in terms of recurrence and complications.