Brazilian and Argentinean Multicentric Study in the Surgical Minimally Invasive Treatment of Pilonidal Cyst

Abstract

Background: The pilonidal cyst is an infection of the skin and the subcutaneous tissue, secondary to a chronic inflammation with a greater frequency in the sacrococcygeal region, and associated to the presence of hair. The treatment is eminently surgical. Aim: To demonstrate the endoscopic treatment of pilonidal cyst. Method: Prospective study with 67 patients who had as surgical indication the diagnosis of pilonidal cyst. They were submitted to a surgical procedure from June 2014 to March 2018. The equipment used was the Meinero fistuloscope, a shutter, a monopolar electrode, a brush and endoscopic forceps. Results: Of the 67 patients, 67% (n=45) were male and 33% (n=22) female, with a mean age of 25 years (17-45). Surgical time in average was 40 min (20-120) and mean healing time of four weeks (3-12). Surgical complications were presented in 7% cases (n=5) and recurrences in 9% (n=6). Conclusion: The endoscopic treatment of the pilonidal cyst is feasible and presents good surgical results.

Endoscopic sinusectomy: ‘a rose by any other name’. A systematic review of different endoscopic procedures to treat pilonidal disease

“…Sequeira et al [21] and Gökbuget et al [39] assessed the safety and effectiveness of EPSiT in the paediatric population, Chia et al [40] in the Asian population and Mendes et al [41] in the Brazilian and Argentinean populations. In patients with complicated PD, EPSiT yielded a significantly lower success rate but a lower risk of complications compared to the Limberg flap procedure [23].…”

“…TA B L E 4 IDEAL checklists for IDEAL Stages 2a and 2b Milone [28] Milone [52] Milone [22] Esposito [31] Esposito [30] Dotlacil [53] Pérez-Bertólez [64] Gulcu [27] Meinero [29] Chia [40] Gecim [49] Sequeira [21] Pini Prato [55] Khafagy [56] Romaniszyn [23] Gökbuget [39] Giordano [42] Gallo [59] Yuksel [33] Baxter [34] Javed [20] Jain [63] Stage Manigrasso [26] Manigrasso [35] Esposito [32] Esposito [24] Esposito [25] Meinero [37] Giarratano [54] Meinero [38] Mendes [41] Kalaiselvan [57] Azhough [58] Foti [60] Gulcu [61] Hinksman [62] A prospective multicentre trial showed a quick postoperative recovery and a good quality of life after EPSiT [37]. A prospective international multicentre study on 122 patients with recurrent PD showed a complete wound healing in 95% of patients, within a mean time of 29 days.…”

“…Sequeira et al [21] and Gökbuget et al [39] assessed the safety and effectiveness of EPSiT in the paediatric population, Chia et al [40] in the Asian population and Mendes et al [41] [30,31]. They standardized the technique suggesting preoperative and postoperative laser epilation [32] and oxygen-enriched oil-based gel dressing [25] to decrease the risk of recurrence, while promoting faster wound healing and higher patient satisfaction.…”

Endoscopic approach to complex or recurrent pilonidal sinus: A retrospective analysis

“…Since its introduction, several studies have been published to evaluate the outcomes of endoscopic technique gaining the interest of several surgeons. 2 , 14 , 15 , 16 , 17 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Most of these studies were non‐comparative or retrospective and were performed on a relatively small population. However, two comparative studies 37 , 38 and a RCT were published 2 to compare endoscopic approaches to PSD with traditional surgical treatments.…”

“…The endoscopic technique involves identification of the sinus cavity and its lateral tracks by endoscopic view, identification of hair and its removal, complete resection of sinus cavity and accurate debridement and irrigation of the sinus cavity. Since its introduction, several studies have been published to evaluate the outcomes of endoscopic technique gaining the interest of several surgeons 2,14‐17,26‐36 . Most of these studies were non‐comparative or retrospective and were performed on a relatively small population.…”