�ocuk ya� grubunda endoskopik pilonidal sin�s tedavisi (EPSiT): Erken sonu�lar

G�kbuget, Zeynep Merve; �zcan, Rah�an; Karag�z, Ay�e; T�t�nc�, Ay�e �i�dem; Topuzlu Tekant, Gonca

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�ocuk ya� grubunda endoskopik pilonidal sin�s tedavisi (EPSiT): Erken sonu�lar [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2021; 27(4): 443-448 | DOI: 10.14744/tjtes.2020.74677

�ocuk ya� grubunda endoskopik pilonidal sin�s tedavisi (EPSiT): Erken sonu�lar

Zeynep Merve G�kbuget¹, Rah�an �zcan¹, Ay�e Karag�z¹, Ay�e �i�dem T�t�nc�², Gonca Topuzlu Tekant¹
¹�stanbul �niversitesi-Cerrahpa�a, Cerrahpa�a T�p Fak�ltesi, �ocuk Cerrahisi Anabilim Dal�, �stanbul
²�stanbul �niversitesi-Cerrahpa�a, Cerrahpa�a T�p Fak�ltesi, Anesteziyoloji Anabilim Dal�, �stanbul

AMA�: Pilonidal sin�s (PS) tedavisinde endoskopik pilonidal sin�s tedavisi (EPSiT) y�nteminin erken d�nem sonu�lar�n� de�erlendirmektir.
GERE� VE Y�NTEM: Haziran 2018�Temmuz 2019�da EPSiT y�ntemiyle tedavi edilen olgular geriye d�n�k olarak incelendi. Olgular�n demografik verileri, cerrahi i�lem s�resi, ameliyat sonras� a�r�, hastanede kal�� s�resi, normal aktiviteye ge�i� ve yara iyile�me s�resi ve EPSiT i�leminin sonu�lar� de�erlendirildi.
BULGULAR: Yirmi dokuz olgunun (20 erkek, 9 k�z) ya� ortalamas� 15.5�2.8 ya� idi. V�cut kitle indeksi (VK�) ortalamas� 25.8�4.2 idi. Sekiz olgu (%28) d�� merkezde giri�im sonras� n�ksle ba�vurmu�tu. Fist�l say�s� ortalama 1.17 (1�2) idi. Fist�l lokalizasyonu olgular�n 24��nde orta hat, be�inde lateral yerle�imliydi. EPSiT i�leminin s�resi ortalama 57�13.9 dakika, hastanede kal�� s�resi ortalama 11.4�7.2 saat idi. A�r� skoru ortalama 0.86 (0�3 aras�nda) ve analjezik kullan�m� ortalama 37 saat (12�72 saat) olarak bulundu. Tam yara iyile�mesi primer ba�vuran hastalar i�in 19 g�n (7�60 g�n) idi. Olgular�n 25�inde erken yara iyile�mesi (ortalama 14 g�n) ve d�rd�nde ge� yara iyile�mesi (ortalama 60 g�n) g�r�ld�. �zlem s�resi 8.3�3.34 ay idi. Tam g�nl�k aktiviteye ge�i� 2.1 g�n (0�30 g�n) iken 16 olguda (%53) ayn� g�n idi. Ameliyat sonras� izlemde dokuz olguda erken (kanama: 1) ve ge� (gran�lasyon dokusu: 1, n�ks: 7) komplikasyonlar g�r�ld�. N�ks saptanan sekiz olgunun (%27.5) yedisi primer, biri n�ks sonras� ba�vurmu�tu. N�ks g�r�lme s�resi ortalama 5.8�2.8 ay idi. Bu sekiz olgunun ikisine re-EPSiT yap�ld�, biri takipten ��kt�, be�ine tekrar EPSiT planlanmaktad�r.
TARTI�MA: Endoskopik pilonidal sin�s tedavisi y�ntemi kolay uygulanabilir, a�r�s�z, k�sa hastanede kal�� s�resi olan ve normal g�nl�k aktiviteye h�zl� d�n�� sa�layan minimal invaziv bir y�ntemdir. EPSiT ve di�er tedavi y�ntemleri sonras� g�r�len n�kslerde rahatl�kla ve tekrarlayan uygulamalar yapma olana�� sa�lamaktad�r.

Anahtar Kelimeler: �ocuk, EPSiT; fist�loskop; pilonidal sin�s.

Endoscopic pilonidal sinus treatment (EPSiT) in the pediatric age group: Short-term results

Zeynep Merve G�kbuget¹, Rah�an �zcan¹, Ay�e Karag�z¹, Ay�e �i�dem T�t�nc�², Gonca Topuzlu Tekant¹
¹Department of Pediatric Surgery, �stanbul University-Cerrahpa�a, Cerrahpa�a Faculty of Medicine, �stanbul-Turkey
²Department of Anesthesiology, �stanbul University-Cerrahpa�a, Cerrahpa�a Faculty of Medicine, �stanbul-Turkey

BACKGROUND: This study aims to evaluate the short term outcomes of the Endoscopic pilonidal sinus treatment (EPSiT) in the pediatric age group.
METHODS: In this study, between June 2018 and July 2019, pediatric patients with pilonidal sinus (PS) who were treated with the EPSiT method were reviewed retrospectively.
RESULTS: Of the twenty-nine patients (20 males, nine females), the average age was 15.5�2.8 years, and the average body mass index (BMI) was 25.8�4.2. Eight patients (28%) presented with a history of recurrence following the previous surgery. The average number of fistulas present in cases was 1.17 (1�2). The localization of the fistula was midline in twenty-four and lateral in five of the patients. The average time of the EPSiT procedure was 57�13.9 minutes, and the average time of hospital stay was 11.4�7.2 hours. The pain score average was 0.86 (range of 0�3) and the duration of analgesic use was 37 hr (12�72 hr). The mean post-operative time of total wound healing was 18.71 days (7�60 days) for primary presenting cases. Early wound healing was seen in twenty-five patients (average of 14 days), while late wound healing was observed in four patients (average of 60 days). The mean time of follow-up was 8.3�3.34 months. The average time of return to full daily activity was 2.1 days (0�30 days), while it was the same day for sixteen (53%) patients. In post-operative follow-up, early (bleeding: 1) and late (formation of granulation tissue: 1, recurrence: 8) complications were seen in nine patients. Of the eight patients (27.5%) whose recurrence was detected, seven were primary and one was secondary presenting patients. The average time of presentation for recurrence was 5.8 mo (1�10 mo). Re-EPSiT was applied in two of the eight patients with recurrence and is planned for five, while one of the patients lost to follow-up.
CONCLUSION: EPSiT is an easily applicable, pain-free minimal invasive procedure with a short period of hospital stay and a fast return to routine daily activity. It provides comfortable and repeatable intervention in cases with recurrences after the EPSiT procedure and other methods for PS treatment.

Keywords: Children, EPSiT; fistuloscope; pilonidal sinus.

Sorumlu Yazar: Rah�an �zcan, T�rkiye
Makale Dili: �ngilizce

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