Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review

Tien, Tony; Athem, R.; Arulampalam, T

doi:10.1007/s10151-018-1803-4

Cited by 48 publications

(42 citation statements)

References 21 publications

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“…Early post-operative morbidity should be taken into special consideration as it greatly interferes with patients' quality of life, especially when postoperative complications such as dehiscence occur. As many others, this study shows that EPSiT improves psychological state, social function and pain (7, 19, 21, 22). Pit-picking is reported to have the same results, like it was expected, once EPSiT only complements Pit-picking with the endoscopic view (23).…”

Section: Discussionsupporting

confidence: 83%

Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center

et al. 2019

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Background: Sacrococcygeal Pilonidal Disease (PD) is commonly treated with excision and primary closure techniques (EPC). Minimally invasive techniques (MIT), such as EPSiT and Pit-picking , had been recently advocated promising better outcomes. We analyzed mid-term results from our center after introduction of MIT to treat PD. Methods: Patients submitted to MIT ( n = 44) with a median follow-up of 37 months were analyzed and compared with patients submitted to EPC ( n = 70) with a median follow-up of 5 years. Both groups included patients operated in our department between 2011 and 2016 and have similar demographic and clinical characteristics. We compared operative time and post-operative parameters such as time with pain, dressing time and time to relapse. Results: The post-operative time with pain was significantly lower, whereas the dressing time was significantly longer, in MIT when compared to the EPC group. The relapse rate was similar in both groups but the follow-up is shorter in the MIT group. In addition, the analysis of patients free of disease using Kaplan-Meier curves revealed that relapse tends to occur more precociously in MIT than in EPC patients ( p = 0.014). Interestingly, in the subgroup of patients with previous surgery, MIT's relapse rate was significantly lower than in the EPC group (30 vs. 100%, p < 0.001). Conclusions: MIT has the advantage of having a shorter time with pain in the postoperative period, while EPC benefits from a shorter dressing time. In general, the relapse of the disease tends to manifest more precociously in MIT patients. Moreover, in the subgroup of patients with previous surgery, MIT seems to have significantly better results when compared to EPC.

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Section: Discussionsupporting

confidence: 83%

Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center

et al. 2019

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“…In addition, several recent systematic reviews have analysed EPSiT/VAAPS application from published case series along with the one randomised trial published to date. Tien et al showed patients undergoing EPSiT/VAAPS to have reduced time off work, low short term recurrence and high satisfaction scores although the technique took longer to perform and required specialist, expensive equipment [ 70 ]. Furthermore, Emile et al assessed 497 patients across 9 studies (6 prospective, 2 retrospective and 1 RCT) [ 71 ].…”

Section: The Future Of Pilonidal Sinus Surgery: the Shift Towards Endmentioning

confidence: 99%

Pilonidal sinus disease: Review of current practice and prospects for endoscopic treatment

Mahmood

Hussain

Akingboye

2020

Annals of Medicine and Surgery

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Pilonidal sinus disease is chronic acquired condition leading to significant morbidity and associated healthcare costs. Several techniques have been described to manage this condition with no treatment gaining universal acceptance. With the shift towards minimally invasive surgery, Video Assisted-Ablation of Pilonidal Sinus (VAAPS) and Endoscopic Pilonidal Sinus Treatment (EPiST) have gained prominence. The aim of this review is to analyse current treatment modalities and the evidence for endoscopic pilonidal sinus surgery. Reported surgical techniques range from wide excision with or without primary closure to various flap closures. These aim to eliminate the underlying causes driven by natal cleft hair and reducing recurrence. However, long term (≥5 years) recurrence rates range between 10 and 30% with significant complication rates. Trials with endoscopic treatment which have shown comparable short-term results to established treatments with reduced morbidity. However, the potential higher cost, learning curve, patient selection criteria and need for long term outcomes from randomised trials limit widespread application of this promising method. Endoscopic treatment of pilonidal sinus disease therefore provides a minimally invasive alternative to traditional surgical methods with the potential to reduce morbidity. However long-term outcomes data from further prospective randomised trials is needed to establish its efficacy compared to traditional surgical methods.

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“…In zwei systemischen Metaanalysen [161,460], die 8 bzw. 9 Studien aus 6 Zentrenund 497 Patientenbeinhalteten, wurde ein Therapieversagen von 8 % (4 % Rezidive und 4 % persistierende Befunde) berechnet.…”

Section: Endoskopische Verfahrenunclassified

S3-Leitlinie: Sinus pilonidalis. 2. revidierte Fassung 2020

2020

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Beteiligte Fachgesellschaften Deutsche Gesellschaft für Koloproktologie (DGK); federführend Deutsche Gesellschaft für Allgemein-und Viszeralchirurgie (DGAV) Chirurgische Arbeitsgemeinschaft für Coloproktologie (CACP) Berufsverband der Coloproktologen Deutschlands (BCD) Deutsche Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselkrankheiten (DGVS) Deutsche Dermatologische Gesellschaft (DDG) 1. Einleitung und Definition Der Pilonidalsinus oder Sinus pilonidalis (pilus = Haar, nidus = Nest) ist eine akut oder chronisch verlaufende Entzündung im subkutanen Fettgewebe, überwiegend im Bereich der Steißbeinregion.

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Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review

Abstract: Initial studies on EPSiT have shown promising results. However, there is a need for a standardised technique and more comparative studies to validate this novel procedure.

Cited by 48 publications

References 21 publications

Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center

Minimally Invasive Surgical Treatment of Pilonidal Disease: Mid-Term Retrospective Analysis of a Single Center

Pilonidal sinus disease: Review of current practice and prospects for endoscopic treatment

S3-Leitlinie: Sinus pilonidalis. 2. revidierte Fassung 2020

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