Department of General Surgery, University of Medical Sciences, Tabriz, Iran.
Islamic Azad University Tabriz Branch, Faculty of Medicine, Tabriz, Iran.
Asian J Endosc Surg. 2021 Jul;14(3):458-463. doi: 10.1111/ases.12893. Epub 2020 Nov 12.
Pilonidal sinus disease (PSD) is a common skin and subcutaneous disease that is mainly seen in men (mean age, 30 years); its incidence rate is 26 cases per 100 000. PSD greatly affects quality of life. Ideally, a surgical procedure to treat PSD should involve a minimal hospital stay and require minimal time off work, discomfort, operative time, and cost; it should also limit recurrence. In this study, we present a new minimally invasive technique for pilonidal sinus surgery known as endoscopic pilonidal sinus treatment (EPSiT).
From February 2017 to April 2019, 100 patients diagnosed with PSD were treated with the EPSiT method at the Department of General Surgery, Imam Reza Hospital. Patient information was recorded prospectively. During the operation, the fistula cavity and tracts were ablated by an electrode that was introduced through the operative channel. All the epithelial and granulation tissues were removed by a brush inserted into the operative channel or by a Volkmann spoon.
None of the patients had postoperative complications, such as hematoma, seroma, or wound infection, during the follow-up period. Recurrence was seen four patients (4%). At 1 week postoperatively, the visual analog scale score was 3 for 37 patients (37%) and 2 for 28 patients (28%). The maximal cosmetic satisfaction rate was reported in 85 patients (85%).
As a minimally invasive procedure, EPSiT is effective for treating PSD. Compared with excision and primary closure techniques, EPSiT has a very low recurrence rate after the procedure and a short hospital stay.
藏毛窦疾病（PSD）是一种常见的皮肤和皮下疾病，主要见于男性（平均年龄 30 岁）；其发病率为每 10 万人中有 26 例。PSD 极大地影响了生活质量。理想情况下，治疗 PSD 的手术应尽量减少住院时间和工作缺勤，减少不适、手术时间和成本；也应限制复发。在这项研究中，我们提出了一种新的微创技术，称为内镜藏毛窦治疗（EPSiT），用于治疗藏毛窦。
从 2017 年 2 月至 2019 年 4 月，普外科共收治 100 例 PSD 患者，采用 EPSiT 方法治疗。前瞻性记录患者信息。在手术过程中，通过引入手术通道的电极来消融瘘管腔和窦道。通过插入手术通道的刷子或 Volkmann 勺去除所有上皮和肉芽组织。
在随访期间，所有患者均无术后并发症，如血肿、血清肿或伤口感染。有 4 例（4%）患者复发。术后 1 周，37 例（37%）患者的视觉模拟评分（VAS）为 3 分，28 例（28%）患者为 2 分。85 例（85%）患者报告最大美容满意度。
作为一种微创方法，EPSiT 治疗 PSD 有效。与切除和一期缝合技术相比，EPSiT 术后复发率非常低，住院时间短。
