Advancing pilonidal disease care through pediatric endoscopic treatment (PEPSiT): early insights.
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BACKGROUND: Pilonidal Sinus Disease (PSD) is an acquired inflammatory condition with no standard treatment. We evaluated our initial experience with Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT). METHODS: We retrospectively reviewed all PEPSiT cases from May 2021-January 2025. Data collected included demographics, presentation, comorbidities, BMI, surgical time, anesthesia, hospital stay, complications, healing, recurrence, and follow-up (median, range). RESULTS: Thirty-two patients (18 males) underwent PEPSiT, median age 15 years (11-18), BMI 26.6 kg/m² (16.7-51.6). None had prior surgery for PSD. Three had comorbidities (two with type 1 diabetes, one with Hemophilia B). Median operative time was 39 min (19-58). All were day surgery procedures; 28 under sedation/local and 4 under general anesthesia. Median healing was 3 months (1-24). Complications included one granuloma (treated with silver nitrate) and one hematoma. All resumed normal activities the next day. Median follow-up was 9 months (1-52). Three recurrences were successfully treated with redo-PEPSiT. CONCLUSION: Our outcomes suggest that PEPSiT is a safe, effective option for PSD. However, larger prospective studies are needed.