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Pediatric endoscopic pilonidal sinus treatment (PEPSiT) as standard of care results over 10 years’ experience in 507 patients

Year: 2026

Type: article

Abstract: Pilonidal sinus disease (PSD) is an acquired inflammatory condition of the gluteal cleft predominantly affecting teenagers. We report our 10-year experience adopting this minimally invasive approach, pediatric endoscopic pilonidal sinus treatment (PEPSiT). We retrospectively reviewed all patients, with primary or recurrent PSD, undergoing PEPSiT in the 2016-2025 period. We operated 507 patients (313 boys and 194 girls) with a median age of 15.5 years (IQR 12-18 years). All patients received our postoperative management. Data regarding success rate, healing rate/time, post-operative management, short- and long-term outcome and patient satisfaction were assessed. The post-operative course was painless in 100% of patients (median VAS pain score < 2/10, IQR 1-2). Patient satisfaction was excellent (median score 4.8/5, IQR 4-5). Dressing after surgery was performed with ozone oil products in every patient and in the last 18 months Platelet-Rich Plasma (PRP) has been added to the intra and post-operative care too. Disease recurrence occurred in 53/507 patients (10.4%), mostly within 3 months (range 2 months-23 months), and all were successfully re-operated with PEPSiT with no further recurrence. This study demonstrates that a standardized perioperative protocol, including tailored pre- and post-operative management and structured long-term follow-up, is effective in ensuring favorable clinical outcomes, with negligible pain, high patient satisfaction and a low rate of recurrence.

Source: Scientific Reports

DOI: 10.1038/s41598-026-50716-7