Ciro Esposito1, Francesco Turrà2, Mariapina Cerulo2, Fulvia Del Conte2, Giorgia Esposito2, Alessio Pini Prato3, Maria Escolino2. 1. Division of Pediatric Surgery, Federico II University of Naples, Naples, Italy. Electronic address: ciroespo@unina.it. 2. Division of Pediatric Surgery, Federico II University of Naples, Naples, Italy. 3. Division of Pediatric Surgery, The Children Hospital, AON, SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Abstract
PURPOSE: This study aimed to standardize the technique of pediatric endoscopic pilonidal sinus treatment (PEPSiT) associated with laser epilation. METHODS: All pediatric patients presenting with acute or chronic pilonidal sinus disease (PSD) who underwent PEPSiT in our institution over a 36-month period (July 2015-July 2018), were included in the study. Pre- and postoperative management, recurrence rate, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated. RESULTS: A total of 59 patients (23 girls and 36 boys) underwent PEPSiT during the study period. Ten/59 patients (16.9%) had recurrent PSD after open repair, and 4/59 (6.7%) presented a concomitant pilonidal cyst. All children underwent laser epilation pre- and postoperatively over the last 15 months. The average length of surgery was 27.5 min (range 20-45). The average pain score during the first 48 postoperative hours was 2.7 (range 2-5), and the average analgesic requirement was 20 h (range 16-24). The average hospitalization was 22.4 h (range 18-36). At 1 month postoperatively, external openings were healed in all patients. During follow-up, 1 recurrence (1.6%) was recorded and successfully re-treated with PEPSiT. CONCLUSIONS: We believe that PEPSiT represents the technique of choice for treatment of PSD in the pediatric population. It is crucial to standardize the technique consisting of pre- and postoperative laser epilation, PEPSiT, and accurate postoperative wound management with eosin and sulfadiazine spray. LEVEL OF EVIDENCE: Treatment study - Level IV.
PURPOSE: This study aimed to standardize the technique of pediatric endoscopic pilonidal sinus treatment (PEPSiT) associated with laser epilation. METHODS: All pediatric patients presenting with acute or chronic pilonidal sinus disease (PSD) who underwent PEPSiT in our institution over a 36-month period (July 2015-July 2018), were included in the study. Pre- and postoperative management, recurrence rate, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated. RESULTS: A total of 59 patients (23 girls and 36 boys) underwent PEPSiT during the study period. Ten/59 patients (16.9%) had recurrent PSD after open repair, and 4/59 (6.7%) presented a concomitant pilonidal cyst. All children underwent laser epilation pre- and postoperatively over the last 15 months. The average length of surgery was 27.5 min (range 20-45). The average pain score during the first 48 postoperative hours was 2.7 (range 2-5), and the average analgesic requirement was 20 h (range 16-24). The average hospitalization was 22.4 h (range 18-36). At 1 month postoperatively, external openings were healed in all patients. During follow-up, 1 recurrence (1.6%) was recorded and successfully re-treated with PEPSiT. CONCLUSIONS: We believe that PEPSiT represents the technique of choice for treatment of PSD in the pediatric population. It is crucial to standardize the technique consisting of pre- and postoperative laser epilation, PEPSiT, and accurate postoperative wound management with eosin and sulfadiazine spray. LEVEL OF EVIDENCE: Treatment study - Level IV.
Authors: Mackenzie N Abraham; Steven L Raymond; Russell B Hawkins; Atif Iqbal; Shawn D Larson; Moiz M Mustafa; Janice A Taylor; Saleem Islam Journal: Front Surg Date: 2021-02-25
Authors: Michele Manigrasso; Pietro Anoldo; Grazia Cantore; Alessia Chini; Anna D'Amore; Nicola Gennarelli; Francesco Maione; Alessandra Marello; Pietro Schettino; Carmen Sorrentino; Sara Vertaldi; Loredana Maria Sosa Fernandez; Giovanni Domenico De Palma; Marco Milone Journal: Front Surg Date: 2022-01-04