Fistuloscopy in the management of pediatric pilonidal sinus disease

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 ev-ery-day 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.