Comparison of Endoscopic Pilonidal Sinus Treatment Combined With Platelet-Rich Plasma and Excision With Primary Closure in Pediatric Patients: A Retrospective Comparative Cohort Study on Short-Term Outcomes

Abstract

Background: Pilonidal sinus disease (PSD) is a common condition in adolescents, often resulting in recurrence, prolonged recovery, and significant discomfort. Although multiple surgical approaches exist, the optimal treatment for pediatric patients remains unclear. This study aimed to compare the short-term outcomes of endoscopic pilonidal sinus treatment combined with platelet-rich plasma application (EPSIT + PRP) and excision with primary closure (EPC) in children and adolescents with PSD.

Material and methods: This retrospective comparative cohort study analyzed two historical cohorts of pediatric patients with pilonidal sinus disease treated during different time periods at the same institution. A total of 104 patients under 18 years of age were included. EPC was performed in 73 patients between 2010 and 2015, with data retrospectively analyzed. Starting in 2024, 31 newly diagnosed patients were prospectively treated with EPSIT + PRP. PRP was prepared by centrifuging 15 mL of autologous blood at 4000 rpm for 10 min. Patients were evaluated based on demographic features, length of hospital stay, recurrence and complication rates, analgesic use, return to daily life, cosmetic outcomes, and satisfaction.

Results: Of the 104 patients, 65.4 % were male and 34.6 % female. Median age was 16 years in the EPC group and 17 years in the EPSIT + PRP group. Hospital stay was significantly shorter in the EPSIT + PRP group (same-day discharge vs. mean 2.79 days; p < 0.05). In the postoperative 1st year follow-up, recurrence rates were 13.7 % (EPC) and 9.7 % (EPSIT + PRP), not statistically significant (p = 0.750). Cosmetic satisfaction and return to social life favored the EPSIT + PRP group (p = 0.031).

Conclusion: EPSIT + PRP appears to be a feasible and well-tolerated minimally invasive alternative to EPC in the treatment of PSD in children and adolescents. Despite differences in follow-up duration and study design, short-term outcomes suggest lower recurrence, faster recovery, and better cosmetic satisfaction with EPSIT + PRP.

Keywords: Endoscopic treatment; Minimally invasive; Pilonidal sinus; Platelet-rich plasma; Recurrence.