WOFAPS 2025 8th World Congress of Pediatric Surgery

Nassim Emaratpardaz, Fatih Akbıyık

Ankara Guven Hospital, Department of Pediatric Surgery

Purpose:This study aims to evaluate the outcomes of patients treated in our clinic for sacrococcygeal pilonidal sinus disease using Endoscopic Pilonidal Sinus Treatment (EPSIT), a minimally invasive technique that has gained popularity in recent years.

Methods:Between 2022 and 2025, patients diagnosed with sacrococcygeal pilonidal sinus and treated with EPSIT in our clinic were included. All patients received preoperative antibiotics and were advised regional back epilation. Oral antibiotics were continued for one week postoperatively.
Under general anesthesia and in the jack-knife position, sinus pits were enlarged to allow the introduction of a 3–4 mm cystoscope. Endoscopic cleaning, mucosal cauterization, and irrigation were performed. The area was closed with sterile dressing. All patients were discharged the same day. Daily wound care and weekly follow-ups were conducted. No postoperative activity restrictions were imposed.

Results:A total of 19 patients aged between 9 and 17 years were included in the study. Of these, 13 were male and 6 were female. Two patients had a history of prior open surgical intervention. The follow-up period ranged from 3 to 36 months. The average time to complete healing of the surgical site was 39 days.In 8 patients who did not comply with the epilation recommendation, granulation tissue developed after the 60th postoperative day. This condition was easily treated in the outpatient setting with silver nitrate application. In one patient, recurrence was observed one year after the initial operation, and the patient was successfully re-treated using the EPSIT technique.

Conclusion:EPSIT is a surgical method offering high patient satisfaction due to reduced postoperative pain, minimal activity limitation, smaller scars, and rapid return to daily life.