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The medical records of all pediatric patients, aged up to 18\u00a0years, who underwent PEPSiT in the period 2019\u20132021, were retrospectively reviewed. Patients\u2019 demographics, operative details, and post-operative outcomes were assessed. A total of 294 patients (182 boys), with median age of 14\u00a0years (range 10\u201318), receiving PEPSiT in the study period, were enrolled. Pilonidal sinus disease (PSD) was primary in 258 (87.8%) and recurrent in 36 (12.2%). The median operative time was 36\u00a0min (range 11\u2013120). The median VAS pain score was 0.86 (range 0\u20133) and the median duration of analgesic use was 27\u00a0h (range 12\u201360). The overall success rate was 95.2% (280\/294) and the median time to full healing was 23.4\u00a0days (range 19\u201350). Six\/294 (2.0%) patients developed Clavien 2 post-operative complications. The recurrence rate was 4.8% (14\/294) and all recurrences were re-operated using PEPSiT. Redo-surgery for wound debridement was performed in one (0.3%) patient with late healing. On multivariate analysis, hirsutism and typology of sinus (pits\u2009\u2265\u20092, paramedian and more proximal to the anus) were predictors of PSD recurrence (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). To date, this is the largest series of PEPSiT published in the pediatric population. The outcomes reported after a 3\u00a0years experience confirm that PEPSiT is a safe, effective, and real minimally invasive procedure to treat adolescents with PSD. It provides patients quick and painless recovery, satisfactory success, and high quality of life.<\/jats:p>\n                <jats:p><jats:bold>Graphical abstract<\/jats:bold><\/jats:p>","DOI":"10.1007\/s13304-023-01508-5","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T05:01:45Z","timestamp":1683262905000},"page":"1625-1631","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Pediatric endoscopic pilonidal sinus treatment (PEPSiT): report of a multicentric national study on 294 patients"],"prefix":"10.1007","volume":"75","author":[{"given":"Ciro","family":"Esposito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Leva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Gamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Sgr\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Ferrentino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Papparella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Chiarenza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo","family":"Bleve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mendoza-Sagaon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Montaruli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Escolino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"1508_CR1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/bf00337585","volume":"10","author":"K S\u00f8ndenaa","year":"1995","unstructured":"S\u00f8ndenaa K, Andersen E, Nesvik I, S\u00f8reide JA (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. 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