Treatment of recurrent pilonidal cysts in children: minimally invasive Gips technique

Abstract

Introduction. Currently, long-term outcomes after surgical treatment of pilonidal disease are not always satisfactory. In particular, relapses can reach 40% by different authors and pose a big problem for operating surgeons. Repeated surgical interventions are technically more complicated, often require extensive excision and often lead to rough scars, which worsen cosmetic results. The minimally invasive Gips method has no abovementioned disadvantages and can be used in pilonidal cyst relapses. Purpose. To assess the Gips surgery effectiveness in relapses of pilonidal cysts in children.
Material and methods. 7 children with relapses of pilonidal cysts have been treated with Gips technique in the surgical department of Ivano-Matreninskaya Children's Clinical Hospital (Irkutsk) since January 2020. All surgeries were performed by the generally accepted Gips technique: local infiltration anesthesia with 1% lidocaine solution; fistula excision with a trepan-circular knife and curettage of the pathological cavity. Then, wounds were processed openly with gauze tampons until complete healing.
Results. Gender – 71.4% boys and 28.6% girls. The average age is 16.5 years (12–17 years). Previously performed surgical interventions: excision of the pilonidal cyst – 4 and Gips procedure – 3. Restoration of motor activity – on the first day after surgery. Duration of NSAIDs therapy – 2 days after the procedure. No early postoperative complications were registered. The average length of hospital stay – 4.75 days. Complete healing of postoperative wounds – 4.1 weeks, in average. Catamnesis – 9.5 months , in average; early relapses - in one patient (14.3%).
Conclusion. Minimally invasive intervention for treating pilonidal cysts by the Gips technique can be used both in primary and recurrent forms of the disease. The discussed technique provides good cosmetic results and has a minimal number of postoperative complications.

Keywords

pilonidal cyst / recurrent pilonidal cyst / epithelial-coccygeal course / Gips method / minimally invasive intervention / children

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Russian Journal of Pediatric Surgery