Surgical outcomes of minimally invasive trephine surgery for pilonidal sinus disease with and without laser therapy: a comparative study

• Published in: Techniques in coloproctology Vol. 28; no. 1; p. 13
• Main Authors: Horesh, N., Maman, R., Zager, Y., Anteby, R., Weksler, Y., Carter, D., Nachmany, I., Ram, E.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2024; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Colorectal Surgery; Confounding (Statistics); Female; Gastroenterology; Humans; Laser Therapy; Lasers; Male; Medicine; Medicine & Public Health; Neoplasm Recurrence, Local - surgery; Original Article; Pilonidal Sinus - surgery; Proctology; Recurrence; Retrospective Studies; Surgery; Surgical outcomes; Treatment Outcome; Young Adult; Disease recurrence; Minimally invasive surgery; Pilonidal sinus disease
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-023-02897-w

Background Over the last decades, novel therapeutic options have emerged for the surgical treatment of pilonidal sinus disease (PSD). The aim of this study was to evaluate the outcomes of trephine/pit excision surgery with or without laser therapy in patients with PSD. Methods A retrospective cohort study was conducted at a large tertiary medical center, including all adult patients with PNS who underwent trephine surgery with/without laser therapy between 2016 and 2021[AUTHORS TO INSERT MONTH]. Propensity score matching was used to address confounding factors, and the primary outcome was the 1-year recurrence rate. Results The study included 221 patients with PSD, with a mean age of 23.73 years (87.7% male). In the unmatched cohort (130 trephine surgery alone, 91 trephine surgery + laser therapy), significant differences were observed in mean age (23 vs. 25 years; p  < 0.01)[AUTHROS TO USE MEDIAN PLUS RANGE OR ADD SD] and surgeons’ experience ( p  = 0.014). Propensity score matching was applied to overcome confounding factors, resulting in a matched cohort including 73 patients in each group. The addition of laser therapy demonstrated a significantly lower recurrence rate (8.2% vs. 32.9%; p  < 0.001) compared to pit excision without laser therapy. Logistic regression analysis showed that the addition of laser was significantly associated with a lower risk for recurrence (OR 0.23; 95% CI 0.089–0.633; p  < 0.01). Conclusion The incorporation of laser therapy along with trephine/pit excision surgery significantly reduces the recurrence rate in patients with PNS. Further prospective studies are needed to confirm our findings.