Endoscopic pilonidal sinus treatment (EPSiT) in recurrent pilonidal disease: a prospective international multicenter study
Pilonidal disease (PD) is a common disease of the natal cleft, which can lead to complications including infection and abscess formation. Various operative management options are available, but the ideal technique is still debatable. Recurrent PD after surgical treatment is frequent event for the 25–30% of cases. The present study evaluated endoscopic pilonidal sinus treatment (EPSiT) in recurrent and multi-recurrent PD.
Of the consecutive prospective patients with recurrent PD, 122 were enrolled in a prospective international multicenter study conducted at a secondary and tertiary colorectal surgery centers. Primary endpoint was to evaluate short- and long-term outcomes: healing rate/time, morbidity rate, re-recurrence rate, and patient’s quality of life (QoL).
Complete wound healing rate was occurred in 95% of the patient, with a mean complete wound healing time of 29 ± 12 days. The incomplete healing rate (5%) was significantly related to the number of external openings (p = 0.008), and recurrence was reported in six cases (5.1%). Normal daily activity was established on the first postoperative day, and the mean duration before patients returned to work was 3 days. QoL significantly increased between the preoperative stage and 30 days after the EPSiT procedure (45.3 vs. 7.9; p < 0.0001).
The EPSiT procedure seems to be a safe and effective technique in treating even complex recurrent PD. It enables excellent short- and long-term outcomes than various other techniques that are more invasive.
KeywordsPilonidal disease Recurrent pilonidal sinus Minimally invasive treatment Endoscopic treatment VAAFT
Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data: PM, GL, AS, AC, FF, LR, MLaT. Drafting the article or revising it critically for important intellectual content: PM, GL, AS, AC, FF, LR, MLaT. Final approval of the version to be published: PM, GL, AS, AC, FF, LR, MLaT.
Compliance with ethical standards
Conflicts of interest
Professor Piercarlo Meinero declares to receive financial grants from Karl Storz. The remaining authors declare no potential financial conflict of interest related to this study.
- 1.McCallum I, King PM, Bruce J (2007) Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev (4):CD006213 Review. Update in: Cochrane Database Syst Rev. 2010;(1):CD006213Google Scholar
- 3.Bascom J (1980) Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery 87:567–572Google Scholar
- 5.Tejirian T, Lee JJ, Abbas MA (2007) Is wide local excision for pilonidal disease still justified? Am Surg 73(10):1075–1078Google Scholar