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Pediatric endoscopic pilonidal sinus treatment: lessons learned after 100 consecutive cases.

S Pérez-Bertólez1, I Casal-Beloy2, A Pasten2,3

  • 1Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2. 08950, Barcelona, Spain. spbertolez@yahoo.es.

Techniques in Coloproctology
|December 10, 2024
PubMed
Summary
This summary is machine-generated.

Pediatric endoscopic pilonidal sinus treatment (PEPSiT) offers faster healing and fewer complications compared to traditional methods. This minimally invasive approach allows children to return to normal activities sooner with better outcomes.

Keywords:
ChildrenEndoscopic treatmentMinimally invasive surgeryPEPSiTPilonidal sinusPilonidal sinus disease

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Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Techniques
  • Pilonidal Sinus Management

Background:

  • Pilonidal sinus disease affects children and adolescents.
  • Conventional surgical treatments like excision and healing by secondary intention (EHSI) or excision and primary closure (EPC) have limitations.
  • Long-term outcomes of pediatric endoscopic pilonidal sinus treatment (PEPSiT) require further evaluation.

Purpose of the Study:

  • To compare the effectiveness and advantages of PEPSiT versus conventional surgical techniques for pilonidal sinus in pediatric patients.
  • To assess healing time, pain, return to normal life, complications, and recurrence rates.

Main Methods:

  • A quasi-experimental study involving 149 pediatric patients from 2019-2022.
  • Comparison of three surgical approaches: PEPSiT (100 patients), EHSI (28 patients), and EPC (21 patients).
  • Surgical technique selection was dependent on the surgeon's discretion.

Main Results:

  • PEPSiT demonstrated significantly faster healing (median 4 weeks) compared to EHSI (16 weeks) and EPC (7 weeks) (p < 0.01).
  • Lower pain scores (VAS) and reduced need for analgesics were observed in the PEPSiT group (p < 0.01).
  • PEPSiT led to a significantly earlier return to normal life and had substantially lower complication and recurrence rates than EHSI and EPC.

Conclusions:

  • Endoscopic pilonidal sinus treatment (PEPSiT) is an effective medium-term surgical option for pediatric pilonidal sinus.
  • PEPSiT offers significant advantages over classic techniques, including reduced complications and faster recovery.
  • Patients treated with PEPSiT can return to normal life without restrictions, indicating a favorable functional outcome.