P132 Minimally invasive techniques in the management of pilonidal disease

Published Date: 11th September 2019

Publication Authors: Kalaiselvan R

Background
Pilonidal sinus disease remains a challenging entity because of the high morbidity of most treatment options and recurrence of symptoms. Minimally invasive methods have been described to minimise the morbidity associated with wound care and reduce time off work. We undertook this systematic review to study the effectiveness of endoscopic pilonidal sinus treatment (EPSiT).

Methods
Electronic searches were performed on five major databases from 1950 to April 2016. Eligibility decisions, methodological quality, data extraction and analysis were performed according to predefined clinical criteria. The primary endpoint was to determine complication rate using EPSiT. The secondary endpoints were to determine recurrence rate, return to work (days), wound healing time and pain.

Results
Ten papers including six clinical trials were analysed. 142 EPSiT patients were included with 76 of these in a clinical trial. There were no statistically significant difference demonstrated in complication rate (5.6% vs 3.4%) and recurrence rate (4% vs 7.5%) when comparing patients in a single EPSiT trial with sinusectomy and sinotomy. However, proportion meta‐analysis favoured a minimally invasive method, comprising sinusectomy, sinotomy or EPSiT, compared to excision treatment. Study heterogeneity meant results could not be pooled, but this review suggests quicker return to work and wound healing time and better pain scores favouring EPSiT.

Conclusion
This systematic review demonstrates that EPSiT may offer a safe and effective method for the management of Pilonidal sinus disease. Further randomised controlled high‐powered trials are required to more accurately define its effectiveness and closely evaluate the side effect profile.

Reader, H; Kalaiselvan, R; Rajasundaram, R. (2019 ). P132 Minimally invasive techniques in the management of pilonidal disease. Colorectal Disease. 21 (Supp 2), 35-36.

 

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