Umberto Bosio Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, EU, Italy.
Pediatr Surg Int. 2022 Sep;38(9):1257-1261. doi: 10.1007/s00383-022-05162-7. Epub 2022 Jul 2.
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.
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.
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).
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.
内镜下骶尾部窦道切除术（EPSiT）已被证明具有出色的疗效，其并发症和复发率均较低。本研究旨在报告单中心一组接受 EPSiT 治疗的儿科患者的长期结果，该组患者在 5 年内接受了该手术。
我们回顾性分析了 2017 年 1 月至 2021 年 12 月期间接受 EPSiT 的患者。纳入首次手术时年龄小于 18 岁的患者。记录患者的人口统计学数据、手术过程和复发情况。患者还被分为短期（随访 12 个月）和长期（随访超过 36 个月），以比较结果并发现所有可能的延迟复发。
5 年内共有 99 例患者接受了 115 次 EPSiT 手术。中位年龄为 16 岁（8-19 岁）。中位手术时间为 32 分钟（25-50 分钟）。其中 83 例患者进行了短期结果评估，报告的复发率为 8%，平均发生在术后 6 个月。59 例患者至少随访了 36 个月（长期结果），中位随访时间为 49 个月（36-61 个月），报告的复发率为 15%，平均发生在术后 19 个月。所有复发的患者均需再次接受 EPSiT 治疗。5 例患者发生感染（2 例复发），1 例患者发生出血（无复发）。
最近的报告强调了 EPSiT 的显著效果和极低的复发率。我们的回顾性研究报告了长期结果，似乎并不支持这些预期。即便如此，EPSiT 仍然是一种简单、直接的手术方法，可实现快速康复，因此被认为是治疗骶尾部窦道疾病最有前途的手术技术之一。EPSiT 将继续存在并发展。
