Vol.:(0123456789) 1 3 Pediatric Surgery International (2018) 34:687–692 https://doi.org/10.1007/s00383-018-4262-0 ORIGINAL ARTICLE Preliminary report on endoscopic pilonidal sinus treatment in children: results of a multicentric series Alessio Pini Prato 1  · Cinzia Mazzola 2  · Girolamo Mattioli 2  · Maria Escolino 3  · Ciro Esposito 3  · Antonio D’Alessio 4  · Laura Caterina Abati 4  · Lorenzo Leonelli 2  · Claudio Carlini 1  · Franco Rotundi 1  · Pier Carlo Meinero 5 Accepted: 5 April 2018 / Published online: 19 April 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Background Pilonidal disease is a troublesome acquired condition for whom various surgical treatments have been proposed with relatively high recurrence and complication rates. Since EPSiT technique has been described in 2013, it became an alternative treatment in adult practice. Our study reports the results of a multicentre series of pediatric patients who under- went EPSiT procedure over a 21-month period. Methods Between July 2015 and March 2017, all consecutive patients undergoing EPSiT in four diferent pediatric surgi- cal units have been enrolled. Details regarding demographic data, detailed surgical procedure, outcome and complications have been recorded. Results A total of 43 patients underwent EPSiT procedure. Mean age was 15 years. There was a slight female preponder- ance. Mean weight and height at surgery were 67 kg and 168 cm, respectively. In 14% of cases a previous inefective pro- cedure was performed. Mean length of procedure was 34 min and median hospital stay was 24 h (12–72 h). Median length of follow-up was 4 months (range 3–18 months). Complications leading to reoperation were reported in 9% of cases with an overall resolution rate of 88%. Discussion EPSiT proved to be feasible and safe even in the pediatric population. The efectiveness and safety of the proce- dure suggest that this technique can represent a valid alternative for the treatment of pilonidal disease in children. Keywords Abscess · Children · EPSiT · Pilonidal disease · VAAFT Introduction Pilonidal disease is an acquired condition characterized by the presence of median or paramedian openings at the intergluteal groove deriving from ingrowing of hair into the deep sacrococcygeal subcutaneous tissue [1]. Sondenaa et al. reported in 1995 the most salient clinical features of patients. The calculated incidence of the disease proved to be of 26 into 100,000 with a strong male preponderance. Reported male-to-female ratio was 2.2:1 [2]. The onset in adoles- cence seems to be due to the increased sebum and hirsutism compared to younger children [1]. The management of this annoying issue, which can have an onset up 2 years before medial referral, is debated and many diferent approaches have been proposed so far [1]. Some authors suggested to treat the disease by epilation only, others suggest to simply go for sinus incision and drainage, others suggest marsupial- ization, radical excision with open wound or direct closures. Recently full-thickness fap closures have been suggested to improve results. Regardless of the adopted treatment, the recurrence rate of pilonidal disease proved to remain stable and ranges between 20 and 30% of cases [3–10]. Recently, Meinero et al. published a new minimally invasive technique for the treatment of pilonidal disease in adults [11]. The technique was named endoscopic pilonidal sinus treatment * Alessio Pini Prato a.piniprato@gmail.com 1 Pediatric Surgery, The Children Hospital, AON SS Antonio e Biagio e Cesare Arrigo, Spalto Marengo, 46, 15121 Alessandria, Italy 2 Unit of Pediatric Surgery, Department of Surgery, Giannina Gaslini Institute, Genoa, Italy 3 Pediatric Surgery, Federico II University, Napoli, Italy 4 Pediatric Surgery, Ospedale Civile di Legnano, Milan, Italy 5 Proctological Unit, Department of General Surgery, Sestri Levante Hospital, Genoa, Italy