Pediatric Endoscopic Pilonidal Sinus Treatment, a Revolutionary Technique to Adopt in Children with Pilonidal Sinus Fistulas: Our Preliminary Experience

Esposito, Ciro; Izzo, Serena; Turrà, Francesco; Cerulo, Mariapina; Severino, Giovanni; Settimi, Alessandro; Iannazzone, Marta; Masieri, Lorenzo; Cortese, Giuseppe; Escolino, Maria

doi:10.1089/lap.2017.0246

Cited by 37 publications

(41 citation statements)

References 14 publications

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“…Only one recurrence was observed with no other complications in the 5-10 month follow-up period. Our findings were similar than Esposito et al's work group [10]. The patients, who underwent PEPSiT as re-do surgery after an open procedure (2/9) were satisfied because of the diminished pain and shorter LOS.…”

Section: Discussionsupporting

confidence: 88%

“…But the fistula(s) cannot be explored via visual control, so hairs can remain. Therefore, we have chosen the endoscopic (PEPSiT) method [10] and shared our positive experience and results during our learning curve.…”

Section: Discussionmentioning

confidence: 99%

“…However, some authors put more emphasis both on pre-, and postoperative hair removal [9]. Due to advanced minimal invasive surgery, it became a solution to operate pilonidal sinus with endoscopic method named Paediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) [10]. This treatment is clearly a minimal invasive one, making it possible to explore the fistulae, remove hairs and make debridement via the fistuloscopy.…”

Section: Purposementioning

confidence: 99%

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Paediatric endoscopic pilonidal sinus treatment: it is time to forget the open procedure?

2020

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Purpose Our aim was to study the learning curve results with Paediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT). Methods A retrospective observational study was performed in paediatric patients (< 18 year) with PEPSiT procedure. Complications, length of hospital stay and recurrence rate were analysed. Result In 2019, during the study period, 12 PEPSiT procedures were done. One patient was excluded from the study, because of the loss of follow-ups and two of them because of the use of the cystoscope. Intra-or postoperative complications were not found and 1/9 recurrence was observed. Length of stay was 1 day for all patients. Conclusion Although there is limited experience in PEPSiT, it seems to be a feasible procedure. The length of hospital stay is shorter than after open surgery. Further studies are needed to evaluate the long-term results with PEPSiT.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Purposementioning

confidence: 99%

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Paediatric endoscopic pilonidal sinus treatment: it is time to forget the open procedure?

2020

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“…We modified the endoscopic technique, first described by Meinero in adults ( 10 ), in order to apply it in the pediatric population and we called it PEPSiT (Pediatric Endoscopic Pilonidal Sinus Treatment) ( 12 ). After a 3-year experience with PEPSiT, we believe that the key factor to achieve the complete healing of PSD was not only the standardization of the surgical procedure but also pre- and post-operative laser epilation and accurate post-operative wound treatment ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in Children With Pilonidal Sinus Disease: Tips and Tricks and New Structurated Protocol

et al. 2020

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Background: The advent of pediatric endoscopic pilonidal sinus treatment (PEPSiT) has dramatically changed the surgical management of pilonidal sinus disease (PSD) in children and adolescents. This study aimed to report the outcome of our new structurated protocol, including PEPSiT, laser epilation, and oxygen-enriched oil-based gel dressing, for treatment of PSD in pediatric patients and describe tips and tricks of the technique. Methods: We retrospectively reviewed the data of 127 pediatric patients, who underwent PEPSiT for PSD in our institutions over a 36-month period. All patients received laser epilation (LE) before and after surgery. Post-operative dressing was performed using silver sulfadiazine spray and in the last 18 months oxygen-enriched oil-based gel. We divided the patients in two groups according to the protocol adopted: G1 (laser + oxygen-enriched oil-based gel dressing) included 72 patients and G2 (laser + silver sulfadiazine spray dressing) included 55 patients. The two groups were compared regarding success rate, recurrence, wound infection rate, wound healing time, post-operative outcome, time to full daily activities and patient satisfaction. Results: No difference emerged between the two groups regarding the average operative time, the average post-operative pain score, the average analgesic requirement, the average hospitalization and the average time to full daily activities ( p = 0.33). No intra- or post-operative complications including wound infection occurred in both groups. The patients required an average number of 7 LE sessions (range 4–10) to achieve complete hair removal. The overall success rate was significantly higher in G1 ( n = 71, 98.6%) compared with G2 ( n = 50, 90.9%) [ p = 0.001]. The recurrence rate was also significantly lower in G1 ( n = 1, 1.4%) compared with G2 ( n = 5, 9%) [ p = 0.001]. Furthermore, G1 reported a faster wound healing (average 21 days) compared with G2 (average 29 days) [ p = 0.001] and a higher patient satisfaction score (average 4.9) compared with G2 (average 4.2) [ p = 0.001]. Conclusions: Based upon our experience, PEPSiT may be considered the standard of care for surgical treatment of PSD in children and adolescents. Our new structurated protocol consisting of pre-operative LE, PEPSiT, and post-operative wound management with oxygen-enriched oil-based gel dressing and LE, allowed to achieve an excellent outcome, with a success rate > 98%.

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“…In summary, in the era of minimally invasive surgery, EPSiT appears to be a safe and promising technique for the treatment of pilonidal sinus disease, with multiple authors emphasising its particular role in the paediatric population . However, this technique has yet to be standardised and its cost‐effectiveness, long‐term outcomes, and applicability to recurrent disease, as well as its comparative efficacy and safety against current surgical options need further evaluation.…”

Section: Chronic Disease Treatmentsmentioning

confidence: 99%

Management of sacrococcygeal pilonidal sinus disease

Harries

Alqallaf

Torkington

et al. 2018

International Wound Journal

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The ideal treatment for patients who suffer from pilonidal sinus disease should lead to a cure with a rapid recovery period allowing a return to normal daily activities, with a low level of associated morbidity. A variety of different surgical techniques have been described for the primary treatment of pilonidal sinus disease and current practice remains variable and contentious. Whilst some management options have improved outcomes for some patients, the complications of surgery, particularly related to wound healing, often remain worse than the primary disease. This clinical review aims to provide an update on the management options to guide clinicians involved in the care of patients who suffer from sacrococcygeal pilonidal sinus disease.

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Pediatric Endoscopic Pilonidal Sinus Treatment, a Revolutionary Technique to Adopt in Children with Pilonidal Sinus Fistulas: Our Preliminary Experience

Cited by 37 publications

References 14 publications

Paediatric endoscopic pilonidal sinus treatment: it is time to forget the open procedure?

Paediatric endoscopic pilonidal sinus treatment: it is time to forget the open procedure?

Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in Children With Pilonidal Sinus Disease: Tips and Tricks and New Structurated Protocol

Management of sacrococcygeal pilonidal sinus disease

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