Comparison of conventional incision and drainage for pilonidal abscess versus novel endoscopic pilonidal abscess treatment (EPAT)

Javed, M A; Fowler, Harriet; Jain, Yogesh; Singh, Sandeep; Scott, M; Rajaganeshan, R

doi:10.1007/s10151-016-1546-z

Cited by 18 publications

(16 citation statements)

References 4 publications

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“…Long-term results of RCT ( 14) demonstrated a similar recurrence rate between two groups in a 5-year follow-up, but in a small group of patients. The feasibility of the endoscopic surgery for chronic and recurrent pilonidal disease has encouraged surgeon in its adoption even in the acute pilonidal abscess (25,43,45). For this reason, the endoscopic pilonidal abscess treatment (EPAT) was introduced by Javed et al (43).…”

Section: Discussionmentioning

confidence: 99%

“…The feasibility of the endoscopic surgery for chronic and recurrent pilonidal disease has encouraged surgeon in its adoption even in the acute pilonidal abscess ( 25 , 43 , 45 ). For this reason, the endoscopic pilonidal abscess treatment (EPAT) was introduced by Javed et al ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

“…Since its introduction, two comparative studies have been performed over the last years ( 25 , 43 ), demonstrating that the endoscopic approach to acute pilonidal sinus was associated with reduced postoperative pain and lower duration of wound healing and time off work, with no differences in terms of definitive surgery needed.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Treatment of Pilonidal Sinus Disease: State of Art and Review of the Literature

et al. 2022

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Background: Pilonidal sinus disease (PSD) is a chronic troublesome pathology of the natal cleft of the sacrococcygeal region, with an estimated incidence of 26 cases in every 100,000 inhabitants. The aim of this review is to give a snapshot of the current literature on the endoscopic approach to PSD.Methods: A search on endoscopic treatment of pilonidal disease was performed according to PRISMA guidelines, adopting the following search terms: (pilonidal OR sacrococcygeal) and (endoscopic OR VAAPS OR EPSiT OR minimally invasive OR video-assisted OR video assisted).Results: Thirty-four articles were included in the final analysis, among which 23 were on adults and 11 were on pediatric population. The endoscopic approach is associated with painless postoperative pain, good aesthetic results, short time off work, and high patient satisfaction.Despite these advantages in short-term outcomes, results on recurrence rate in a long-term follow up are needed to definitively confirm the importance of this technique.Conclusions: The endoscopic approach is associated with significant postoperative advantages over other standard surgical approaches, and it should be included in the surgical portfolio for the treatment of PSD. According to the Italian guidelines, this technique could be considered as the gold standard for limited PSD. However, the favorable short-term-outcomes and lack of reliable data on long-term follow-up must be a stimulus to perform further high-quality studies to give definitive conclusions on this technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endoscopic Treatment of Pilonidal Sinus Disease: State of Art and Review of the Literature

et al. 2022

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“…Recently, minimally invasive techniques have been suggested to also treat the acute presentation of PD [ 26 , 27 ]. For instance, in a small study comparing simple incision and drainage vs. endoscopic pilonidal abscess treatment (EPAT) (20 patients in each group), EPAT seemed to be associated with a shorter time to wound healing (16 vs. 35 days, p = 0.0018), but the same number of cases required further conclusive surgery (20% [ 26 ] or 21% [ 27 ]).…”

Section: Methodsmentioning

confidence: 99%

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease

et al. 2021

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Pilonidal disease (PD) is a relatively common, benign but challenging condition of the natal cleft. This consensus statement was drawn up by a panel of surgeons, identified by the Italian Society of Colorectal Surgery (SICCR) as having a “special interest” in PD, with the aim of recommending the best therapeutic options according to currently available scientific evidence. A three-step modified-Delphi process was adopted, implying: (1) choice of the panelists; (2) development of a discussion outline and of target issues; and (3) a detailed systematic review of the current literature. The agreement/disagreement level was scored on a five-point Likert scale as follows: “A + : strongly agree; A–: agree; N: unsure/no opinion; D–: disagree; D + : strongly disagree. Each panelist contributed to the production of this manuscript, and the final recommendations were reviewed by the Clinical Practice Guidelines Committee.

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“…Minimally invasive technique was performed in acute disease as well: Javed et al [19] compared traditional incision and drainage with endoscopic treatment for pilonidal abscess and concluded that the endoscopic approach is associated with reduced postoperative morbidity without compromising the adequacy of abscess drainage. Jain et al [20] also reported their experience with minimally invasive endoscopic technique in acute disease, with encouraging results about postoperative morbidity, recurrence rate, and wound healing.…”

Section: Minimally Invasive Approach To Psdmentioning

confidence: 99%

Minimally invasive pilonidal sinus treatment: A narrative review

Velotti

Manigrasso²,

Lauro³

et al. 2019

Open Medicine

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AbstractThe management of chronic pilonidal disease remains controversial, but recently, new minimal invasive approaches have been proposed. Whereas in the conventional surgical treatment an elliptical wedge of skin and subcutaneous tissue is created to remove the sinus and its lateral tracks, the basis for our new treatment is to create a minimal elliptical wedge of the subcutaneous tissue, including all the inflamed tissue and debris while leaving the overlying skin intact.The mechanism of an endoscopic approach relies on use of the endoscope without cutaneous tissue damage. Advantages include shorter operative time and time to discharge, which impact resource management in both primary and secondary care: patients undergoing endoscopic technique have a high satisfaction rate, probably due to the low level of postoperative pain and early return to work and daily activities. However, it is mandatory that further studies would analyze surgical approaches to pilonidal sinus disease (PSD) with a consistent and adequate follow-up of at least 5 years. Both sinusectomy and endoscopic approach to PSD were found to be safe and effective compared with conventional techniques. Publishedresults of studies of newer approaches have demonstrated a low short-term complication rate, comparable to conventional surgery results.

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Comparison of conventional incision and drainage for pilonidal abscess versus novel endoscopic pilonidal abscess treatment (EPAT)

Cited by 18 publications

References 4 publications

Endoscopic Treatment of Pilonidal Sinus Disease: State of Art and Review of the Literature

Endoscopic Treatment of Pilonidal Sinus Disease: State of Art and Review of the Literature

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease

Minimally invasive pilonidal sinus treatment: A narrative review

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