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Pediatric endoscopic pilonidal sinus
treatment can be regarded as the standard of
care for invasive treatment of pilonidal sinus disease in children and adolescents.
As per a recent retrospective review issued in Updates in Surgery, Pediatric endoscopic pilonidal sinus treatment (PEPSiT) was considered as an easy procedure with a short and painless postoperative course and a low rate of recurrence in pilonidal sinus disease (PSD) patients aged less than 18 years. The standardized treatment protocol, accurate patient enrollment, and information, and thorough follow-up contributed to the effectiveness of this treatment.
This review by Ciro Esposito et al. described the tips and tricks of the PEPSiT and its experience over 3 years. The patients with primary or recurrent PSD, undertaking PEPSiT were included. These patients were given laser therapy before the operation, PEPSiT and post-surgery dressing, and laser therapy. Assessment of success rate, healing rate as per time, post-surgery management, short- and long-term outcome, and satisfaction of the patient was done.
Out of the total 152 patients, 15 patients (9.8%) had a recurrent PSD. Following the operation, the patients resumed their routine activities after a day. All the patients experienced a painless post-operative course (Visual Analogue Scale [VAS] pain score <2) with exceptional patient satisfaction. About 95.4% of patients reported complete resolution of symptoms in 8 weeks with a median healing time of 24.6 days.
As per Clavien's
classification of complications, immediate grade 2 (3 oedema and 2 burns) and
delayed grade 2 (3 granulomas and 8 wound infections) complications were
witnessed in 5 (3.3%) and 11 patients (7.2%), respectively after the surgery.
Also, 4.6% of patients were re-operated using PEPSiT due to disease recurrence.
Thus, PEPSiT is a valuable standard of care for surgical therapy of PSD in
children and teenagers.
Updates in Surgery
Pediatric endoscopic pilonidal sinus treatment (PEPSiT): what we learned after a 3-year experience in the pediatric population
Ciro Esposito et al.
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