Video-assisted ablation of pilonidal sinus: A new minimally invasive treatment—A pilot study

Milone, Marco; Musella, Mario; Sardo, Attilio Di Spiezio; Bifulco, Giuseppe; Salvatore, Giuseppe; Fernandez, Loredana Maria Sosa; Bianco, Paolo; Zizolfi, Brunella; Nappi, Carmine; Milone, Francesco

doi:10.1016/j.surg.2013.08.021

Cited by 86 publications

(55 citation statements)

References 11 publications

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“…Minimally invasive treatment has many advantages. Several studies have shown that the period off work after EPSiT is shorter than after more extensive operations . Such patients also tend to experience less pain and better quality of life after endoscopic operation for pilonidal sinus than after classic flap surgery .…”

Section: Discussionmentioning

confidence: 99%

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Long‐term results of endoscopic pilonidal sinus treatment vs Limberg flap for treatment of difficult cases of complicated pilonidal disease: a prospective, nonrandomized study

2019

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Aim To present the results of a prospective, nonrandomized comparative study on the treatment of complicated pilonidal sinus by endoscopic pilonidal sinus treatment (EPSiT) compared with Limberg flap surgery, based on experience of a single surgical centre. Method A prospective, nonrandomized comparative study. Long‐term follow‐up of 62 patients with complicated pilonidal disease was analysed (36 operated on using the Limberg flap technique and 26 using the EPSiT method). The median follow‐up was 27 months (12–44). Results The median operating time in the EPSiT group was 60 min (25–80 min) and in the Limberg group 67 min (35–95 min). In the EPSiT group, primary healing was achieved in 22 out of 26 patients (84.6%) in a median of 42 days with a total complication rate of 11.5%. There were seven recurrences after initial healing. The total success rate of the EPSiT procedure with long‐term follow‐up was 57.7%. In the Limberg flap group, all patients healed (100%) in a median of 21 days. The complication rate in this group was 26.5%, and there were two recurrences in this group. The total success rate of the Limberg flap procedure was 94.1%. Conclusion For patients with complicated pilonidal sinus, the endoscopic procedure has a significantly lower success rate than the Limberg flap procedure, but a lower risk of complications. Such patients should be offered a choice between a safer, minimally invasive procedure with a higher risk of recurrence or flap surgery, which is more effective, but with a higher risk of complications.

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Section: Discussionmentioning

confidence: 99%

“…EPSiT is shorter than after more extensive operations [13][14][15][16][17][18]. Such patients also tend to experience less pain and better quality of life after endoscopic operation for pilonidal sinus [11] than after classic flap surgery [19].…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of endoscopic pilonidal sinus treatment vs Limberg flap for treatment of difficult cases of complicated pilonidal disease: a prospective, nonrandomized study

2019

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“…Rapid healing of the lesion, thanks to the rich blood supply to the face, after adequate excision and curettage, is to be expected 3 4. In recent years, minimally invasive treatment techniques such as endoscopic or video-assisted ablation of pilonidal sinuses have been introduced 11. However, because of the superficial location of the pilonidal sinus in our case, we did not find the need for these techniques.…”

Section: Discussionmentioning

confidence: 62%

Pilonidal sinus of the chin: mistreated as a dental fistula

2016

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Pilonidal sinus is a chronic inflammatory condition associated with penetration of hair particles into the skin. It is rare in the chin area and, to our knowledge, there is only one such reported case. A 56-year-old man was previously admitted to a private clinic, with a hard mass on his anterior buccal sulcus. Three of the patient's teeth were extracted as the swelling was thought to be associated with a dental infection. Because the fistula did not resolve, the patient was referred to our department. Following radiological and clinical examinations, the hard mass was reached intraorally and hair shafts were seen inside it. The area was closed primarily after cleaning the inflammatory tissues and the hairs. The recovery period was uneventful. In this case report, we present a pilonidal sinus encountered in the chin area, the wrong treatment initially given to the patient and the subsequent treatment carried out by us.

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“…The noticeable surgical scar resulting after skin flap creation might be one reason that patients prefer a non-invasive method. A recent study of the VADA method, which also offers a good opportunity to clean up hair and debris from the SPD cavity under direct vision, reported 3.7% recurrence after 1 year of follow-up 5. In contrast, CPA never provides an optimal opportunity to clean up the cavity.…”

Section: Discussionmentioning

confidence: 99%

Video-assisted treatment of pilonidal disease, using a combination of diathermy ablation and phenol application

Gecim¹,

Goktug

Celasin³

et al. 2016

BMJ Case Reports

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Video-assisted diathermy ablation (VADA) and crystallised phenol application (CPA) have been independently suggested as minimally invasive treatment options for sacrococcygeal pilonidal disease (SPD). The failure rates may be 5-33% with either method, and these methods have a longer healing time when used alone. Thus, we combined the two methods to fulgurate the infected inner lining of the sinus after cleaning up the hair and debris, and to identify the anatomy of the pilonidal cavity in its entirety, including its branches and cavities, by video assistance; the ultimate aim was to disperse sclerosing phenol crystals for faster healing and potentially less or no recurrence. This is the first case in the literature that has been treated by combining CPA and VADA. The patient healed within less than a month, with no need for professional wound care, and was free of recurrence at 2-year follow-up.

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Video-assisted ablation of pilonidal sinus: A new minimally invasive treatment—A pilot study

Abstract: Our results are encouraging and suggest that this technique may offer a very effective way to treat pilonidal sinus. Further studies are necessary to validate its use in daily practice.

Cited by 86 publications

References 11 publications

Long‐term results of endoscopic pilonidal sinus treatment vs Limberg flap for treatment of difficult cases of complicated pilonidal disease: a prospective, nonrandomized study

Long‐term results of endoscopic pilonidal sinus treatment vs Limberg flap for treatment of difficult cases of complicated pilonidal disease: a prospective, nonrandomized study

Pilonidal sinus of the chin: mistreated as a dental fistula

Video-assisted treatment of pilonidal disease, using a combination of diathermy ablation and phenol application

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