Pilonidal Sinus: Open Surgery or PEPSiT? Our Preliminary Experience in Adolescents

Area of Science:

• Pediatric Surgery
• Minimally Invasive Techniques
• Pilonidal Sinus Disease Management

Background:

• Pilonidal sinus disease (PSD) is a chronic inflammatory condition prevalent in adolescents and young adults.
• Traditional open surgical excision for PSD has limitations including prolonged recovery and high complication rates.
• Endoscopic techniques, like Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT), are emerging as alternatives.

Purpose of the Study:

• To compare the effectiveness and safety of PEPSiT versus traditional open excision for pediatric PSD.
• To evaluate outcomes such as operative time, hospital stay, wound complications, and recurrence rates.

Main Methods:

• Retrospective, non-randomized study of 61 pediatric patients (ages 8-18) with PSD.
• Comparison between traditional open excision (Group A) and PEPSiT (Group B).
• Data collected on demographics, operative time, hospital stay, complications, and recurrence with a minimum 12-month follow-up.

Main Results:

• PEPSiT group had a significantly shorter hospital stay (5.9 vs. 15.40 h, p < 0.001).
• Fewer postoperative complications were observed in the PEPSiT group, with no wound dehiscence compared to 27.5% in the open group (p = 0.008).
• While PEPSiT showed lower recurrence rates (9.5% vs. 25%), this difference was not statistically significant (p = 0.149).

Conclusions:

• PEPSiT is a feasible minimally invasive option for pediatric PSD, demonstrating benefits in hospital stay and complication rates.
• Operative times were comparable between PEPSiT and open surgery.
• Results suggest PEPSiT offers faster wound healing and fewer complications, but prospective controlled studies are warranted for confirmation.