The Epic Procedure For Pilonidal Disease - Endoscopic-Assisted Pilonidal Irrigation And Cleaning
BACKGROUND: Pilonidal disease is a common condition of the sacrococcygeal region caused by invagination of hair follicles leading to inflammation and abscess formation. Many surgical options have been employed for its management; minimally-invasive techniques have more recently been investigated. Our technique, the "EPIC procedure:" Endoscopic-assisted Pilonidal Irrigation and Cleaning, involves removal of trapped hair with the aid of an endoscope while flushing with saline. We aim to show that the EPIC procedure is a safe and effective operation for the treatment of pilonidal disease in the pediatric population.
METHODS: This study is a retrospective chart review including 10 consecutive patients who presented to a single pediatric surgeon at a single institution from December, 2016 to September, 2018. We evaluated gender, age, weight, disease severity, operative duration, recurrence of pilonidal disease, and other complications.
RESULTS: Ten patients were included in the study; 11 EPIC procedures were completed. The median follow up duration was 1.6 (range 0.2-15.9) months. The median operative duration was 27 (13-60) minutes. The rate of recurrence of pilonidal cyst in our sample was 10% (95% CI: 0.25%, 44.5%). One patient developed a fungal-appearing infection. There were no other complications.
DISCUSSION: There is currently no standard procedure for the treatment of pilonidal disease. Our study had a single recurrence in a patient who did not follow postoperative bathing and hair removal instructions. He underwent repeat EPIC procedure and had no further recurrence. The EPIC procedure is a minimally invasive technique that is easy, fast, and effective.