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Short- and mid-term results of diode laser treatment in pilonidal sinus disease and the role of endoscopic camera use on outcomes

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Abstract

Purpose

Nowadays, surgical treatment of pilonidal sinus disease (PSD) with novel techniques is a topic of interest since conventional methods are associated with longer return to daily life and higher complication and recurrence rates. Recently, use of laser as a minimally invasive approach has become popular in the surgical treatment of PSD. In this study, we analyze the short- and mid-term results after laser treatment and the effect of endoscopic camera use on outcomes.

Methods

A total of 106 patients with PSD who underwent laser treatment between November 2017 and September 2021 were included in this study. All patients were treated with a 1470-nm diode laser. Endoscopic camera was used in 73 patients and results of these were compared with those in whom camera was not used. Follow-up period was determined as a minimum of 1 year. Data were analyzed retrospectively.

Results

There were 80 (75%) male and 26 female patients. The median age was 26 (range 13–50) years. On the first postoperative day, 26 (26.5%) patients did not have any pain and 42(42.8%) patients reported low-grade pain. The mean time to return to daily life was 4.5 ± 5.5 (median 2, range 1–30) days. The complication rate was 10.4%. Eighty-six (87.8%) patients completely recovered and the mean complete recovery time was 27.4 ± 15.9 days. The patient satisfaction rate was 99.0%. The recurrence rate was 11.0%. Neither history of previous surgery nor abscess was associated with recurrence. Use of an endoscopic camera had no effect on postoperative pain, complete recovery, complications, patient satisfaction, and recurrence (p < 0.05).

Conclusion

Laser treatment for PSD is a promising approach with the advantages of less postoperative pain, early return to daily life, high patient satisfaction, and acceptable complication and recurrence rates. Nevertheless, further studies are needed to investigate the role of endoscopic camera use in this procedure since its possible advantages could not be clarified.

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Data availability

The data set analyzed during the current study are available in the Google Spreahsheet repository https://docs.google.com/spreadsheets/d/15VIWXd3n72ebs-KJs4OKom6UEPXes5HlLOwVILjFGAQ/edit#gid=0.

Change history

  • 23 December 2023

    The original article has been corrected. Hyperlink is removed from Data Availability statement.

References

  1. Dessily M, Charara F, Ralea S, Allé JL (2017) Pilonidal sinus destruction with a radial laser probe: technique and first Belgian experience. Acta Chir Belg 117(3):164–168. https://doi.org/10.1080/00015458.2016.1272285

    Article  PubMed  Google Scholar 

  2. Romic I, Augustin G, Bogdanic B, Bruketa T, Moric T (2022) Laser treatment of pilonidal disease: a systematic review. Lasers Med Sci 37(2):723–732. https://doi.org/10.1007/s10103-021-03379-x

    Article  PubMed  Google Scholar 

  3. Johnson EK, Vogel JD, Cowan ML, Feingold DL, Steele SR, Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons (2019) The American Society of Colon and Rectal Surgeons’ clinical practice guidelines for the management of pilonidal disease. Dis Colon Rectum 62(2):146–157. https://doi.org/10.1097/DCR.0000000000001237

    Article  PubMed  Google Scholar 

  4. Sluckin TC, Hazen SJA, Smeenk RM, Schouten R (2022) Sinus laser-assisted closure (SiLaC®) for pilonidal disease: results of a multicentre cohort study. Tech Coloproctol 26(2):135–141. https://doi.org/10.1007/s10151-021-02550-4

    Article  PubMed  Google Scholar 

  5. Beal EM, Lee MJ, Hind D, Wysocki AP, Yang F, Brown SR (2019) A systematic review of classification systems for pilonidal sinus. Tech Coloproctol 23(5):435–443. https://doi.org/10.1007/s10151-019-01988-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Awad MM, Elbaset AA, Ebraheem S, Tantawy E, Elhafez MA, Elsayed AM (2009) A scoring system as a method to evaluate pilonidal sinus disease to make an easy decision for its management. Indian J Plast Surg. 42(1):43–48. https://doi.org/10.4103/0970-0358.53011

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tezel E (2007) A new classification according to navicular area concept for sacrococcygeal pilonidal disease. Colorectal Dis 9(6):575–576. https://doi.org/10.1111/j.1463-1318.2007.01236.x

    Article  CAS  PubMed  Google Scholar 

  8. Hjermstad MJ, Fayers PM, Haugen DF et al (2011) Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manag 41(6):1073–1093. https://doi.org/10.1016/j.jpainsymman.2010.08.016

    Article  Google Scholar 

  9. Likert R (1932) A technique for the measurement of attitudes. Arch Psychol 22(140):55

    Google Scholar 

  10. Pappas AF, Christodoulou DK (2018) A new minimally invasive treatment of pilonidal sinus disease with the use of a diode laser: a prospective large series of patients. Colorectal Dis 20(8):O207–O214. https://doi.org/10.1111/codi.14285

    Article  CAS  PubMed  Google Scholar 

  11. Dessily M, Dziubeck M, Chahidi E, Simonelli V (2019) The SiLaC procedure for pilonidal sinus disease: long-term outcomes of a single institution prospective study. Tech Coloproctol 23(12):1133–1140. https://doi.org/10.1007/s10151-019-02119-2

    Article  CAS  PubMed  Google Scholar 

  12. Lord Ph, Dm M (1965) Pilonidal sinus: a simple treatment. Br J Surg 52:298–300. https://doi.org/10.1002/bjs.1800520413

    Article  CAS  PubMed  Google Scholar 

  13. Bascom J (1980) Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery 87(5):567–572

    CAS  PubMed  Google Scholar 

  14. Stauffer VK, Luedi MM, Kauf P et al (2018) Common surgical procedures in pilonidal sinus disease: a meta-analysis, merged data analysis, and comprehensive study on recurrence. Sci Rep 8(1):3058. https://doi.org/10.1038/s41598-018-20143-4.PMID:29449548;PMCID:PMC5814421

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Gips M, Melki Y, Salem L, Weil R, Sulkes J (2008) Minimal surgery for pilonidal disease using trephines: description of a new technique and long-term outcomes in 1,358 patients. Dis Colon Rectum 51:1656–1663

    Article  PubMed  Google Scholar 

  16. Wilhelm A (2011) A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol 15(4):445–449. https://doi.org/10.1007/s10151-011-0726-0

    Article  CAS  PubMed  Google Scholar 

  17. Georgiou GK (2018) Outpatient laser treatment of primary pilonidal disease : the PiLaT technique. Tech Coloproctol 22(10):773–778. https://doi.org/10.1007/s10151-018-1863-5

    Article  PubMed  Google Scholar 

  18. Milone M, Velotti N, Manigrasso M, Milone F, Sosa Fernandez LM, De Palma GD (2019) Video-assisted ablation of pilonidal sinus (VAAPS) versus sinusectomy for treatment of chronic pilonidal sinus disease: a comparative study. Updates Surg 71(1):179–183. https://doi.org/10.1007/s13304-018-00611-2

    Article  PubMed  Google Scholar 

  19. Algazar M, Zaitoun MA, Khalil OH, Abdalla WM (2022) Sinus laser closure (SiLaC) versus Limberg flap in management of pilonidal disease: a short-term non-randomized comparative prospective study. Asian J Surg 45(1):179–183. https://doi.org/10.1016/j.asjsur.2021.04.026

    Article  PubMed  Google Scholar 

  20. Esposito C, Mendoza-Sagaon M, Del Conte F et al (2020) Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in children with pilonidal sinus disease: tips and tricks and new structurated protocol. Front Pediatr 24(8):345. https://doi.org/10.3389/fped.2020.00345

    Article  Google Scholar 

  21. Milone M, Velotti N, Manigrasso M, Anoldo P, Milone F, De Palma GD (2018) Long-term follow-up for pilonidal sinus surgery: a review of literature with metanalysis. Surgeon 16(5):315–320. https://doi.org/10.1016/j.surge.2018.03.009

    Article  CAS  PubMed  Google Scholar 

  22. Meinero P, Mori L, Gasloli G (2014) Endoscopic pilonidal sinus treatment (E.P.Si.T.). Tech Coloproctol 18(4):389–392. https://doi.org/10.1007/s10151-013-1016-9

    Article  CAS  PubMed  Google Scholar 

  23. Mahmood F, Hussain A, Akingboye A (2020) Pilonidal sinus disease: review of current practice and prospects for endoscopic treatment. Ann Med Surg (Lond) 1(57):212–217. https://doi.org/10.1016/j.amsu.2020.07.050

    Article  Google Scholar 

  24. Kalaiselvan R, Liyanage A, Rajaganeshan R (2020) Short-term outcomes of endoscopic pilonidal sinus treatment. Ann R Coll Surg Engl 102(2):94–97. https://doi.org/10.1308/rcsann.2019.0097

    Article  CAS  PubMed  Google Scholar 

  25. Meinero P, Stazi A, Carbone A, Fasolini F, Regusci L, La Torre M (2016) Endoscopic pilonidal sinus treatment: a prospective multicentre trial. Colorectal Dis 18(5):O164–O170. https://doi.org/10.1111/codi.13322

    Article  CAS  PubMed  Google Scholar 

  26. Gulcu B, Ozturk E (2022) Endoscopic pilonidal sinus treatment vs. laser-assisted endoscopic pilonidal sinus treatment: short-term results from a retrospective case-matched study. Tech Coloproctol 26(4):271–277. https://doi.org/10.1007/s10151-021-02568-8

    Article  PubMed  Google Scholar 

  27. Segre D, Pozzo M, Perinotti R, Roche B, Italian Society of Colorectal Surgery (2015) The treatment of pilonidal disease: guidelines of the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol 19(10):607–613. https://doi.org/10.1007/s10151-015-1369-3

    Article  CAS  PubMed  Google Scholar 

  28. Iesalnieks I, Ommer A (2019) The management of pilonidal sinus. Dtsch Arztebl Int 116(1–2):12–21. https://doi.org/10.3238/arztebl.2019.0012

    Article  PubMed  PubMed Central  Google Scholar 

  29. Yardimci VH (2020) Outcomes of two treatments for uncomplicated pilonidal sinus disease: Karydakis flap procedure and sinus tract ablation procedure using a 1,470 nm diode laser combined with pit excision. Lasers Surg Med 52(9):848–854. https://doi.org/10.1002/lsm.23224

    Article  PubMed  Google Scholar 

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Funding

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Authors and Affiliations

  1. Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey

    I. A. Bilgin, M. Tanal, N. Ramoglu, V. Ozben, I. Sahin, A. Aghayeva, A. A. Sahar, O. Saylik, B. Baca, I. Hamzaoglu & T. Karahasanoglu

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  1. I. A. Bilgin
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  2. M. Tanal
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  3. N. Ramoglu
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  4. V. Ozben
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Contributions

Conceptualization: IAB, BB, IH, TK. Methodology: IAB, IS, BB, IH, TK; Formal Analysis and investigation: IAB, MT, VO, IS, AA; Writing—original draft preparation: IAB, MT, NR, VO; Writing—review and editing: IAB, MTl, NR, VO, AAS, OS; Resources: IAB, IS, BB, TK; Supervision: BB, IH, TK.

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Correspondence to I. A. Bilgin.

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The authors do not have any conflict of interest.

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Informed consent was obtained from all patients.

Ethical approval

The study protocol was approved by the Ethics Committee of Acibadem Mehmet Ali Aydinlar University (ID number 2022-20/01).

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Bilgin, I.A., Tanal, M., Ramoglu, N. et al. Short- and mid-term results of diode laser treatment in pilonidal sinus disease and the role of endoscopic camera use on outcomes. Tech Coloproctol 27, 921–928 (2023). https://doi.org/10.1007/s10151-023-02831-0

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