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Comparison of five different treatment techniques for pilonidal disease in adolescents: a 13-year experience

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Abstract

Purpose

The authors aimed at comparing multiple operative methods for pilonidal disease (PD) and to determine the optimal treatment modality.

Methods

The authors assessed paediatric patients treated with PD between January 2008 and January 2021. Out of 276 patients, 255 met with the inclusion criteria. The total number of treatments were 340 for these 255 patients. Of these 340, the five modalities of therapy were incision only (INC n = 90), direct closure with drainage (DCW n = 172) and without drainage (DWO n = 19), paediatric endoscopic pilonidal sinus treatment (PEPSIT n = 37), and open wound treatment (OWT n = 22). Patients were categorized by age, sex, length of hospital stay (LOS), wound healing time, wound complications, use of antibiotics, and need for repeated hospitalization.

Results

Wound healing was the fastest after INC and the slowest in OWT. Females were treated less invasively than males. Use of antibiotics was the highest in DWO. Wound complications were lowest in INC and OWT; and the same in all other treatment modalities. Repeated hospitalization rate was the highest after INC. Length of stay (LOS) was lowest in PEPSIT and in INC, and by far the highest in OWT. Drainage time was the shortest after INC.

Conclusion

Multiple techniques are known for the treatment of PD. Neither technique proved to be significantly better. However, the authors recommend the use of PEPSIT because of its minimal invasiveness, shortest LOS, and consequent minimal patient discomfort.

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Funding

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Author notes

  1. Zoltan Ringwald and Balazs Fadgyas have contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery and Traumatology, Heim Pal National Institute of Paediatrics, 86 Ulloi Street, Budapest, 1089, Hungary

    Mark Langer, Krisztina Adrienne Tiborcz, Zoltan Ringwald & Balazs Fadgyas

  2. Division of Paediatric Surgery, Traumatology, Urology and Paediatric Otolaryngology of Department of Paediatrics, Pecs Medical Centre, University of Pecs, 7 Jozsef Attila Street, Pecs, 7623, Hungary

    Peter Vajda

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  1. Mark Langer
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  2. Peter Vajda
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  5. Balazs Fadgyas
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Correspondence to Mark Langer.

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Langer, M., Vajda, P., Tiborcz, K.A. et al. Comparison of five different treatment techniques for pilonidal disease in adolescents: a 13-year experience. J Ped Endosc Surg 4, 55–61 (2022). https://doi.org/10.1007/s42804-021-00124-7

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  • DOI: https://doi.org/10.1007/s42804-021-00124-7

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