Abstract:

Aim: Pilonidal sinus (PS) is an inflammatory disease of the sacrococcygeal region that negatively affects the life of the individual. Although there are many treatment modalities for the disease, a gold standard treatment method has not yet been determined. It was aimed to compare the endoscopic PS treatment method with other treatment methods in pediatric patients treated for PS in a second-line provincial hospital. Method: After obtaining approval from Erzurum Regional Training and Research Hospital Ethics Committee with the decision number 2020/06-66, pediatric patients under 18 years of age who were operated for PS in Muş Provincial Hospital between January 2017 and January 2020 were retrospectively analyzed. Patients were operated in the prone position, under spinal anesthesia by using total excision + primary closure, total excision + limberg flap, and endoscopic PS treatment (EPSIT) + phenol application methods. Patients’ age, gender, length of hospital stay, time to return to work or school, and minor and major complications were analyzed. Results: Forty eight patients in pediatric age group were included in the study. The average age of the patients was 16,18 years; 20 (41.6%) of the patients were male and 28 (58.3%) were female. The hospitalization period was 3,48 days and the average follow-up period was 480 days (16 months). Time to return to work was 10,6 (3-28) days. Forty eight patients underwent surgery. Limberg flap method was used in 13, primary closure method in 9 and EPSIT method in 26 patients. Six patients had recurrence, 5 patients developed minor complications such as seroma and necrotic fat tissue. The hospitalization period was 2 days and the time to return to work was 4.46 days in patients who underwent the EPSIT method, which was superior to the other two methods. The biggest disadvantage of the EPSIT method was the recurrence rate (n=4 patients, 15.3%). Conclusion: Although the recurrence rate of the EPSIT method with phenol application is high, it is more advantageous than other methods due to the short time to return to work or school and shorter hospital stay.

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