Endoscopic Pilonidal Sinus Treatment {Epsit} vs Limberg Flap for Pilonidal Sinus: A Single Center Experience

Abstract

Background: Pilonidal sinus, a condition characterized by chronic irritation in the gluteal cleft, predominantly affects males and is often associated with a higher body mass index and a sedentary lifestyle. Despite its prevalence, a universally accepted gold standard for treatment is yet to be established. This study aimed to compare outcomes between two treatment modalities: endoscopic pilonidal sinus treatment (EPSiT) and the Limberg flap procedure. Materials and Methods: This observational study involved 40 patients undergoing pilonidal sinus treatment at a single tertiary care hospital from April to October 2023. Patients were categorized into two groups based on the chosen procedure, and postoperative pain was assessed using the Visual Analog Scale (VAS). Data on early complications and recurrence rates were recorded in case report forms. The groups were compared, and statistical analysis was conducted using SPSS version 21. Results: Among the total patients, 47% underwent EPSiT, while 53% underwent the Limberg flap procedure. Both groups had an age range of 25-80 years. Intraoperative time for EPSiT was shorter than that for the Limberg flap (25.2±5.0 vs 45.5±5.1 minutes). VAS scores indicated lower postoperative pain in the EPSiT group. Wound healing rates were faster in patients who underwent EPSiT. Short-term recurrence rates were lower in the EPSiT group, although long-term recurrence rates were comparable in both groups. Conclusion: Endoscopic pilonidal sinus treatment demonstrated advantages over the Limberg flap procedure in this study. EPSiT showed shorter operative times, reduced postoperative pain, earlier return to routine activities, and faster wound healing. Furthermore, patients undergoing EPSiT experienced fewer complications such as serous discharge and swelling. While short-term recurrence rates were lower in the EPSiT group, long-term recurrence rates were similar between the two treatment modalities. This study contributes valuable insights into the comparative effectiveness of EPSiT and the Limberg flap procedure for pilonidal sinus treatment.

Keywords

• endoscopic pilonidal sinus treatment (epsit)
• limberg flap procedure
• treatment outcomes
• pilonidal sinus
• surgical modalities