Pediatric endoscopic pilonidal sinus treatment (PEPSiT) for managing pilonidal disease in adolescents

The aim was to evaluate the success rate, complications and recurrence following paediatric endoscopic pilonidal sinus treatment (PEPSiT) in the treatment of pilonidal disease (PD).

A prospective observational study was performed between 01.06.2019 and 30.06.2022 at the author’s institute in patients under 18 years. The indication for PEPSiT was moderate or severe PD. Length of hospital stay (LOS), complications, recurrence, wound healing time (fistula closing) and postoperative hair removal were observed.

During the study period, 51 PEPSiTs (4 redo) were performed in 47pts. The average age of the studied patients was 15.92 years at the operation. LOS was a day in all cases. The regular day activity came back on the 1.07 postoperative day (in average). The fistula closing time was 6.5 (1–24) weeks. Complication observed in 9/47 patients. Recurrence (including non-healed cases) was found in 15/51 (29.4%) cases. The postoperative hair removal was inadequate (23) or missed (7) in 30pts and the majority of recurrent cases (11/15) were found in this group. The overall success rate of PEPSiT was 70.4%.

The main reason of recurrence following PEPSiT could be the insufficient hair removal. The advantage of the procedure is the shorter LOS and faster recovery.