Sonography for adequate clearance during endoscopic management of pilonidal sinus
Sonography in pilonidal sinus
Recently endoscopic technique (EPSiT) has been increasingly used for managing pilonidal sinus disease. The challenge in this technique is to establish complete clearance of all hair and tracts to avoid recurrence.
The aim is to study the use of sonography for adequate clearance of hair and all tracts during EPSiT.
From April 2018 till April 2019, Standard EPSiT was used for managing successive patients seeking management for pilonidal sinus disease (PSD). Upon completion of procedure, intraoperative sonography was done to establish completeness of surgery by ensuring (1) absence of residual hair and (2) dealing of all tracts. All patients were followed in usual way postoperatively by continuing dressing till external pits closed spontaneously. Follow-up was done by monthly outpatient visit and telephonically if they couldn’t come for follow-up.
Twenty patients took part. Sonography provided additional information of residual hair in 2/20 patients, and additional tract in 1/20 patients. More than 3 months follow-up was available for all patients – all were free of complications and recurrence.
Sonography is an important, easily available modality for establishing complete clearance during pilonidal sinus management by the endoscopic technique. Its role can be further judged by bigger sample size and randomized controlled trials.