The endoscopic treatment of pilonidal sinus disease: a short-term case-series study

BACKGROUND: Pilonidal disease (PNS) is a common inflammatory disease that can significantly impact the quality of life of the patient. Previous open techniques for the management of this condition have been unsatisfactory, with high recurrence rates reported. OBJECTIVE: Investigate a new endoscopic procedure for the management of PNS disease. DESIGN: Case series. SETTING: Single hospital in Kuwait. PATIENTS: From April 2014 to October 2017, patients with symptomatic chronic or recurrent PNS were consecutively enrolled to undergo the endoscopic pilonidal sinus treatment (EPSiT) procedure. MAIN OUTCOME MEASURES: Control of pain, wound complications, recurrence rate over a 6-month follow up. SAMPLE SIZE: 35 patients. RESULTS: The mean age of the patients was 22 years, with 33 (94%) males. Fourteen (40%) presented with recurrent disease and were recommended to undergo an EPSiT procedure. A single tract was used in 32 (91%) of the cases, with an average operative time of 51 mins. On follow-up 5 patients reported minimal pain judging by the need of only mild analgesics for the control of pain. No patient experienced early wound complications necessitating hospitalization. There were 2 (6%) recurrences encountered by the time of the 6-month follow-up period. CONCLUSION: In these early results, the EPSiT procedure provided effective healing with acceptable recurrence rates and aesthetics. In addition, the procedure allows the surgeon to see the PNS, fistula tracts or any abscess cavities. LIMITATIONS: Short follow-up period with a small number of patients CONFLICTS OF INTEREST: None.