Minimally Invasive Pilonidal Sinus Treatment: EPSIT Versus PEBAI Method.

Area of Science:

• Surgical Innovation
• Minimally Invasive Procedures
• Proctology

Background:

• Pilonidal sinus disease (PSD) is a chronic condition requiring effective treatment.
• Existing treatments like endoscopic pilonidal sinus treatment (EPSIT) have varying outcomes and costs.
• A novel technique, PEBAI, was developed with similar principles to EPSIT but without endoscopic visualization.

Purpose of the Study:

• To compare the efficacy and outcomes of EPSIT versus the PEBAI method for treating PSD.
• To evaluate secondary endpoints including operative time, pain, wound healing, quality of life, and cost.

Main Methods:

• Retrospective analysis of 104 patients treated with EPSIT and 184 with PEBAI between January 2020 and October 2021.
• Primary endpoint: wound healing. Secondary endpoints: operative time, pain, wound closure, quality of life, cosmetic results, recurrence, and cost.
• Patients were matched for age, sex, BMI, and number of pits.

Main Results:

• Operative time was significantly shorter for PEBAI (20 min) compared to EPSIT (32 min).
• Wound closure time was faster with EPSIT (32 days) than PEBAI (37 days).
• Complete healing, recurrence rates, pain, quality of life, and wound complications were similar between groups. PEBAI was significantly cheaper (€54.8 vs €147.36).

Conclusions:

• The PEBAI method is a viable, cost-effective alternative to EPSIT for pilonidal sinus disease.
• PEBAI achieves comparable clinical outcomes to EPSIT with reduced procedure cost.
• Further research may explore long-term efficacy and patient-reported outcomes.