Fistuloscopy in the management of pediatric pilonidal sinus disease

Osszefoglalo. Bevezetes: A sinus pilonidalis nehezen kezelhető, sok szovődmennyel es recidivaval jaro betegseg. A legtobb műteti eljaras tobbnapos korhazi kezelest, munkabol vagy iskolabol valo hianyzast kovetel. Celkitűzes: Munkank celja, hogy a PEPSiT- (pediatric endoscopic pilonidal sinus treatment) műtetek eredmenyesseget vizsgalja. Modszer: Intezetunkben 2019-2020-ban PEPSiT-műteten atesett, 18 ev alatti betegeket valogattunk be a vizsgalatba. Kizartuk a cisztoszkoppal operalt es kontrollra nem jelentkező betegeket. A szovődmenyek, recidivak szamat, a korhazi tartozkodas hosszat, a sebgyogyulas es a hetkoznapi aktivitashoz valo visszateres idejet vizsgaltuk. Eredmenyek: Betegeink tobbsege fiu (24 fiu, 4 lany), atlageletkoruk 15,6 ev volt. 28 betegen 31 PEPSiT-beavatkozast vegeztunk (3 re-PEPSiT), 6 recidiva, 1 sebgennyedes alakult ki. A betegek egy resze egynapos ellatas kereteben, mig a tobbseg egy ejszaka bentfekves utan tert haza (1,74 nap apolasi idő). A hetkoznapi aktivitashoz 1,37 nap utan tertek vissza, a gyogyulasi idő 5,9 het volt atlagosan. Megbeszeles: A PEPSiT-beavatkozas minimalisan invaziv lehetőseg, igen rovid korhazi tartozkodassal. A betegek hamar ternek vissza a szokott aktivitasukhoz, a korabbi sipolyon kivul ujabb műteti seb nem alakul ki. A recidivaarany hasonlo az egyeb technikakehoz. Kovetkeztetes: A PEPSiT-beavatkozas jol alkalmazhato, a recidivaarany csokkentese fontos. Orv Hetil. 2021; 162(43): 1740-1743. SUMMARY INTRODUCTION The treatment of pilonidal disease is often challenging, due to frequent recurrences and adverse events. Most operative treatments require a lengthy hospital stay, and absence from school or work. OBJECTIVE We aimed towards assessing the effectivity of PEPSiT (pediatric endoscopic pilonidal sinus treatment). METHOD In this study, we included patients subjected to PEPSiT from 2019 to 2020 between ages 0-18 years. Patients operated via cystoscope and patients who did not attend follow-up examinations were excluded. Adverse events, recurrences, length of hospital stay, wound healing time and return to everyday activity were assessed. RESULTS The majority of our patients were male (24 male, 4 female), the mean age was 15.6 years. 31 PEPSiT operations were recorded on 28 patients (3 were redo surgeries). 6 recurrences and 1 wound suppuration were documented. Some patients were treated within the confines of one-day surgery, while most of them stayed one night (mean length of stay was 1.74 days). Return to everyday activity was an average 1.37 days, and mean wound healing time was 5.9 weeks. DISCUSSION PEPSiT is a minimally invasive operative approach with a very short hospital stay. Patients return to everyday activity faster. New operative scarring does not happen apart from the preexisting fistula opening. Recurrence rate is similar to that of other treatment techniques. CONCLUSION PEPSiT technique is applicable, however, reduction of the recurrence rate is important. Orv Hetil. 2021; 162(43): 1740-1743.