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Abstract：
This study aimed to report a multicentric national experience about the outcomes of pediatric endoscopic pilonidal sinus treatment (PEPSiT). The medical records of all pediatric patients, aged up to 18 years, who underwent PEPSiT in the period 2019-2021, were retrospectively reviewed. Patients\' demographics, operative details, and post-operative outcomes were assessed. A total of 294 patients (182 boys), with median age of 14 years (range 10-18), receiving PEPSiT in the study period, were enrolled. Pilonidal sinus disease (PSD) was primary in 258 (87.8%) and recurrent in 36 (12.2%). The median operative time was 36 min (range 11-120). The median VAS pain score was 0.86 (range 0-3) and the median duration of analgesic use was 27 h (range 12-60). The overall success rate was 95.2% (280/294) and the median time to full healing was 23.4 days (range 19-50). Six/294 (2.0%) patients developed Clavien 2 post-operative complications. The recurrence rate was 4.8% (14/294) and all recurrences were re-operated using PEPSiT. Redo-surgery for wound debridement was performed in one (0.3%) patient with late healing. On multivariate analysis, hirsutism and typology of sinus (pits ≥ 2, paramedian and more proximal to the anus) were predictors of PSD recurrence (p = 0.001). To date, this is the largest series of PEPSiT published in the pediatric population. The outcomes reported after a 3 years experience confirm that PEPSiT is a safe, effective, and real minimally invasive procedure to treat adolescents with PSD. It provides patients quick and painless recovery, satisfactory success, and high quality of life.
摘要：
这项研究旨在报告有关小儿内镜下藏毛窦治疗（PEPSiT）结果的多中心国家经验。所有儿科病人的医疗记录,18岁以下,在2019-2021年期间接受PEPSiT的患者进行了回顾性审查。患者人口统计学，操作细节,并对术后结果进行评估.共有294名患者（182名男孩），年龄中位数为14岁（10-18岁），在研究期间接受PEPSiT，已注册。鼻窦病（PSD）主要为258例（87.8％），复发为36例（12.2％）。中位手术时间为36分钟（范围11-120）。中位VAS疼痛评分为0.86（范围0-3），镇痛药使用的中位持续时间为27h（范围12-60）。总体成功率为95.2％（280/294），完全愈合的中位时间为23.4天（范围19-50）。6/294（2.0％）患者出现Clavien2术后并发症。复发率为4.8％（14/294），所有复发均使用PEPSiT重新手术。对一名（0.3％）愈合较晚的患者进行了伤口清创的重新手术。在多变量分析中，多毛症和鼻窦类型(小窝≥2,旁正中和更近肛门)是PSD复发的预测因子(p=0.001).迄今为止,这是儿科人群中发表的最大的PEPSiT系列。3年经验后报告的结果证实PEPSiT是安全的，有效,和真正的微创手术来治疗青少年PSD。它为患者提供了快速和无痛的恢复，令人满意的成功，和高质量的生活。
