Outcomes of Pediatric Endoscopic Pilonidal Sinus Treatment: A Systematic Review.

IF 1.5 3区 医学 Q2 PEDIATRICS
European Journal of Pediatric Surgery Pub Date : 2024-08-01 Epub Date: 2023-07-26 DOI:10.1055/s-0043-1771224
Anastasia Mentessidou, Petros Mirilas, Veniza Maravilla, Georgina Malakounides
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引用次数: 0

Abstract

Treatment of pilonidal sinus disease with conventional excision techniques is associated with recurrence up to 20 to 30% (primary closure) or with prolonged healing that might last months (closure by secondary intention). Endoscopic pilonidal sinus treatment (EPSiT) is gaining increasing popularity. This systematic review aims to summarize and evaluate the reported outcomes of pediatric EPSiT (PEPSiT) to date. Systematic search was performed for all studies on PEPSiT in patients younger than 18 years, pertaining to demographics, technique, and outcomes. Fisher's test was used to assess the associations between success/recurrence rates and different approaches (fistuloscope vs. cystoscope, different wound care protocols). A total of 320 patients (9 studies, 2018-2022) with a weighted mean age of 15.7 years and follow-up duration of 13.5 months were included. PEPSiT was successful in 290 patients (90.9%) with weighted mean time to healing of 4.1 weeks. Recurrence was reported in 29 patients (9.1%) with weighted mean time to recurrence of 4.6 months. Outcomes were not significantly altered by the use of fistuloscope versus pediatric cystoscope (p = 1.0), or with perioperative laser epilation (p = 0.06), or postoperative regular shaving, depilatory creams, light pulse, or laser (p = 0.31). The weighted mean operative time was 38 minutes and hospital stay was 16 hours. Summary of available evidence confirms that PEPSiT is safe and effective. Added to its noninvasiveness, PEPSiT's pooled outcomes appear superior to those of numerous conventional techniques. Comparison with conventional techniques, particularly off-midline flap and semi-closure procedures, is, however, lacking. The superiority of PEPSiT needs to be confirmed in future comparative studies, including cost-benefit analysis.

小儿内镜下乳头状窦治疗的结果:系统回顾
用传统的切除技术治疗朝天鼻窦疾病,复发率高达20%至30%(原发性闭合),或者愈合时间长达数月(继发性闭合)。内窥镜朝天鼻窦治疗(EPSiT)越来越受欢迎。本系统性综述旨在总结和评估迄今为止报道的儿科 EPSiT(PEPSiT)的疗效。我们对所有关于 18 岁以下患者 PEPSiT 的研究进行了系统检索,内容涉及人口统计学、技术和结果。采用费雪氏检验评估成功率/复发率与不同方法(瘘管镜与膀胱镜、不同的伤口护理方案)之间的关联。共纳入320名患者(9项研究,2018-2022年),加权平均年龄为15.7岁,随访时间为13.5个月。290名患者(90.9%)成功实施了PEPSiT,加权平均愈合时间为4.1周。29名患者(9.1%)复发,加权平均复发时间为4.6个月。使用瘘管镜与小儿膀胱镜(P = 1.0)、围术期激光脱毛(P = 0.06)或术后常规剃毛、脱毛膏、光脉冲或激光(P = 0.31)对结果没有明显影响。加权平均手术时间为 38 分钟,住院时间为 16 小时。现有证据总结证实,PEPSiT 是安全有效的。加上其非侵入性,PEPSiT 的综合结果似乎优于许多传统技术。然而,目前还缺乏与传统技术的比较,尤其是离线皮瓣和半闭合手术。PEPSiT 的优越性需要在未来的比较研究中得到证实,包括成本效益分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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