Long-term Results of EPSiT in Children and Adolescents: Still the Right Way to Go

Introduction: Endoscopic pilonidal sinus treatment (EPSiT) has been advocated promising excellent outcomes with low rates of complications and recurrences. In this study, we aimed at reporting long-term results of a unicentric series of pediatric patients who underwent EPSiT during a 5-year period.

Materials And Methods: We retrospectively reviewed patients who underwent EPSiT between January 2017 and December 2021. Patients under 18 years of age at first surgery were included. Details regarding demographic data, surgical procedure, and recurrences were recorded. Patients were also divided into short-term (follow-up of 12 months) and long-term (follow-up longer than 36 months) to compare results and detect all possible delayed recurrences.

Results: A total of 99 patients underwent 115 EPSiT procedures in a 5-year period. Median age was 16 years (8-19 years). Median length of surgery was 32 min (25 to 50 min). Eighty-three of these patients were assessed for short-term results and reported an 8% incidence of recurrences occurring after a mean of 6 months. Fifty-nine patients have been followed up for at least 36 months (long-term results) with a median follow-up of 49 months (36-61 months) and reported a 15% incidence of recurrences occurring after a mean of 19 months postoperatively. All patients who recurred required a redo EPSiT. Infections occurred in 5 (2 recurred) and bleeding in 1 (no recurrence).

Conclusions: Recent reports underlined impressive results and an extremely low recurrence rate of EPSiT. Our retrospective study addressed the long-term results and seems not to support these expectations. Even so, EPSiT remains easy, straightforward, allows rapid recovery and is, therefore, to be considered as one of the most promising surgical techniques available for pilonidal disease. EPSiT is here to stay and to remain.