Endoscopic Treatment of Pilonidal Sinus Disease in Paediatric Patients – A Study in Western Australia

Abstract

Background Pilonidal disease is considered a spectrum of disease ranging from acute abscesses to a chronic state most often associated with draining sinuses in the gluteal fold. An increasing prevalence is seen in children with 3 out of every 250,000 children developing pilonidal sinus disease (PSD). Although this is a common disease within general and paediatric surgery departments worldwide, there is yet to be an agreement on a ‘Gold Standard ‘of treatment. Minimally invasive treatment techniques such as EPSiT are a more recent development for pilonidal disease that are showing promising results. Method This study is a retrospective study of children and adolescents who underwent excision of pilonidal disease using EPSiT by a single paediatric surgeon in Western Australia. The primary outcome measure is recurrence, secondary outcomes include complications, length of hospital stay, time to return to school/work, post-operative pain, and time to complete wound healing. Results No patients suffered recurrence or wound complications at mean follow up of thirteen months. No patients were readmitted to hospital for procedure related complications. All patients reported complete wound healing at an average of twenty-eight days and definitive total wound closure at six weeks post operatively. All patients reported the ability to resume daily activities at 2-4 days post operatively. Conclusion PEPSiT is a promising method of treating paediatric PSD and may represent a new 'Gold Standard’ of treatment in these patients. Our results were comparable to other studies in the literature. However, more studies and large-scale randomized control trials are necessary in the paediatric patient cohort. Level of Evidence: IV