Endoscopic treatment of sacrococcygeal pilonidal sinus (EPSIT): results in 104 patients.

INTRODUCTION

Sacrococcygeal pilonidal sinus (PS) is a common condition in young adults, characterised by an inflammatory response due to hair impaction in the gluteal cleft. Optimal treatment remains controversial because of the morbidity and recurrence associated with conventional techniques. The endoscopic EPSIT technique has emerged as a minimally invasive alternative.

OBJECTIVE

To evaluate the recurrence rate of EPSIT and, secondarily, postoperative complications, healing time, and return to daily activities.

MATERIALS AND

METHODS

Observational study including 104 patients with primary or recurrent sacrococcygeal pilonidal sinus treated with EPSIT between April 2024 and April 2025. The procedure was performed on an outpatient basis under local anaesthesia and intravenous sedation. Demographic variables, operative time, postoperative pain (VAS), analgesic use, complications, healing time, return to activities, and recurrence were recorded.

RESULTS

Most patients were male (76.9%), with a mean age of 31 years. Primary disease was present in 83 cases and recurrent in 21. Mean operating time was 14.2 minutes, and all patients were discharged within 3 hours. Mild postoperative pain (VAS 1-3) was reported in 89.4% of patients. Mean return to activities was 5 days, and mean healing time was 24 days. One surgical site infection was recorded. The recurrence rate was 9.62%.

CONCLUSIONS

EPSIT is a minimally invasive, reproducible technique associated with low morbidity, minimal pain, and rapid recovery, with an acceptable recurrence rate in selected patients.