Minimally invasive treatment of pilonidal cysts in children: the Gips procedure

Abstract

BACKGROUND: Pilonidal disease (pilonidal cyst, epithelial coccygeal passage) is a chronic inflammatory disease of the sacrococcygeal region, common among young people, including adolescents, to a certain extent worsens the quality of life. Until now, the etiopathogenesis and surgical treatment methods of the disease have been the subject of wide discussion. AIM: The aim of the study was to evaluate the effectiveness of Gips operations in children with pilonidal disease. MATERIALS AND METHODS: A comparative analysis of 41 patients with pilonidal disease was conducted in the surgical department of the City Ivano-Matryoninsk Children's Clinical Hospital in Irkutsk from January 2020 to August 2021. Planned surgical treatment was performed in 22 patients with primary or recurrent pilonidal cysts, including 15 children using the M. Gips procedure. The comparison group consisted of patients who underwent wide excision of a complex of soft tissues bearing a pilonidal cyst, primary and secondary fistulous passages, followed by wound restoration with a storey suture. RESULTS: The patients comprised 72.7% boys and 27.3% girls with an average age of 15.6 1.5 years and average disease duration of 5.1 2.2 months. The average operation time was 12 4.2 minutes. The motor regime was resumed on the first day after the operation. Patient pain was relieved by administering non-steroidal anti-inflammatory drugs for the first two postoperative days. There were no early postoperative complications. The average hospital stay was 3.8 1.9 days. Complete healing by secondary intention was achieved after an average of 3.9 1.8 weeks. The average follow-up was 7 3.8 months, and 6.7% had early relapses. CONCLUSIONS: Minimally invasive sinusectomy according to the Gips procedure for treating pilonidal disease in adolescents is safe and effective, has a low recurrence rate, allows an early return to daily activities, and provides a good cosmetic result. However, the small number of observations requires further research.