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Published in: Techniques in Coloproctology 5/2018

01-05-2018 | Review

Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review

Authors: T. Tien, R. Athem, T. Arulampalam

Published in: Techniques in Coloproctology | Issue 5/2018

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Abstract

Background

Pilonidal sinus is a common disease of the natal cleft, which can lead to complications including infection and abscess formation. Various operative management options are available, but the ideal technique is still debatable. More recently minimally invasive approaches have been described. Our aim was to review the current literature on endoscopic pilonidal sinus treatment (EPSiT) and its outcomes.

Methods

A systematic literature review was conducted and reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of EMBASE, MEDLINE and Cochrane Library was conducted in November 2017. Full-text studies on the use of endoscopy for the treatment of pilonidal sinus were included in the review.

Results

Initial search results returned 52 articles. Eight studies (eight case series and one randomised control trial) were included in the final qualitative synthesis. These studies demonstrated that EPSiT has good complete healing rates and low recurrence rates. There was also a high level of patient satisfaction and little time taken off work. Two studies reported modifications to the original technique. The main limitation was the lack of comparative studies.

Conclusions

Initial studies on EPSiT have shown promising results. However, there is a need for a standardised technique and more comparative studies to validate this novel procedure.
Literature
1.
go back to reference Søndenaa K, Andersen E, Nesvik I, Søreide JA (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 10(1):39–42CrossRefPubMed Søndenaa K, Andersen E, Nesvik I, Søreide JA (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 10(1):39–42CrossRefPubMed
2.
go back to reference McCallum I, King PM, Bruce J (2007) Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev McCallum I, King PM, Bruce J (2007) Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev
3.
go back to reference Chintapatla S, Safarani N, Kumar S, Haboubi N (2003) Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol 7:3–8 Chintapatla S, Safarani N, Kumar S, Haboubi N (2003) Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol 7:3–8
4.
go back to reference Segre D, Pozzo M, Perinotti R, Roche B (2015) The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol 19:607–613 Segre D, Pozzo M, Perinotti R, Roche B (2015) The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol 19:607–613
5.
go back to reference Allen-Mersh TG (1990) Pilonidal sinus: finding the right track for treatment. Br J Surg 77:123–132CrossRefPubMed Allen-Mersh TG (1990) Pilonidal sinus: finding the right track for treatment. Br J Surg 77:123–132CrossRefPubMed
7.
go back to reference Guner A, Ozkan OF, Kece C, Kesici S, Kucuktulu U (2013) Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients. Color Dis 15(7) Guner A, Ozkan OF, Kece C, Kesici S, Kucuktulu U (2013) Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients. Color Dis 15(7)
8.
go back to reference Keshava A, Young CJ, Rickard MJFX., Sinclair G (2007) Karydakis flap repair for sacrococcygeal pilonidal sinus disease: How important is technique? ANZ J Surg 77(3):181–183CrossRefPubMed Keshava A, Young CJ, Rickard MJFX., Sinclair G (2007) Karydakis flap repair for sacrococcygeal pilonidal sinus disease: How important is technique? ANZ J Surg 77(3):181–183CrossRefPubMed
9.
go back to reference Meinero P, Mori L, Gasloli G (2014) Endoscopic pilonidal sinus treatment (E.P.Si.T.). Tech Coloproctol 18(4):389–392CrossRefPubMed Meinero P, Mori L, Gasloli G (2014) Endoscopic pilonidal sinus treatment (E.P.Si.T.). Tech Coloproctol 18(4):389–392CrossRefPubMed
10.
go back to reference Moher D, Liberati ATJ, AD (2009) The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269CrossRefPubMed Moher D, Liberati ATJ, AD (2009) The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269CrossRefPubMed
14.
go back to reference Milone M, Musella M, Di Spiezio Sardo A, Bifulco G, Salvatore G, Sosa Fernandez LM et al (2014) Video-assisted ablation of pilonidal sinus: a new minimally invasive treatment—a pilot study. Surgery 155(3):562–566CrossRefPubMed Milone M, Musella M, Di Spiezio Sardo A, Bifulco G, Salvatore G, Sosa Fernandez LM et al (2014) Video-assisted ablation of pilonidal sinus: a new minimally invasive treatment—a pilot study. Surgery 155(3):562–566CrossRefPubMed
16.
go back to reference Meinero P, Stazi A, Carbone A, Fasolini F, Regusci L, La Torre M (2016) Endoscopic pilonidal sinus treatment: a prospective multicentre trial. Color Dis 18(5):O164–O170CrossRef Meinero P, Stazi A, Carbone A, Fasolini F, Regusci L, La Torre M (2016) Endoscopic pilonidal sinus treatment: a prospective multicentre trial. Color Dis 18(5):O164–O170CrossRef
18.
go back to reference Kepenekci I, Demirkan A, Celasin H, Gecim IE (2010) Unroofing and curettage for the treatment of acute and chronic pilonidal disease. World J Surg 34(1):153–157CrossRefPubMed Kepenekci I, Demirkan A, Celasin H, Gecim IE (2010) Unroofing and curettage for the treatment of acute and chronic pilonidal disease. World J Surg 34(1):153–157CrossRefPubMed
19.
go back to reference Hameed KK (2001) Outcome of surgery for chronic natal cleft pilonidal sinus: a randomized trial of open compared with closed technique. Med Forum Mon 12(5):20–23 Hameed KK (2001) Outcome of surgery for chronic natal cleft pilonidal sinus: a randomized trial of open compared with closed technique. Med Forum Mon 12(5):20–23
21.
go back to reference McCulloch P, Altman DG, Campbell WB, Flum DR, Glasziou P, Marshall JC et al (2009) No surgical innovation without evaluation: the IDEAL recommendations. Lancet 374:1105–1112CrossRefPubMed McCulloch P, Altman DG, Campbell WB, Flum DR, Glasziou P, Marshall JC et al (2009) No surgical innovation without evaluation: the IDEAL recommendations. Lancet 374:1105–1112CrossRefPubMed
Metadata
Title
Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review
Authors
T. Tien
R. Athem
T. Arulampalam
Publication date
01-05-2018
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 5/2018
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-018-1803-4

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