Outpatient laser treatment of primary pilonidal disease : the PiLaT technique

The aim of the present study was to assess the effectiveness of the minimally invasive technique pilonidal disease laser treatment (PiLaT) in treating primary (non-recurrent) pilonidal disease in an outpatient setting under local anaesthesia.

A prospective observational study was conducted on consecutive patients suffering from primary pilonidal disease that were treated at Iasi Private Medical Center, Ioannina, Greece, between April 2015 and December 2016, using a 1.470 nm diode laser (BioLitec, Germany) emitting energy through a radial optic fiber that was inserted in the cyst and accompanying sinus tracts. Patients were discharged half an hour after completion of the procedure. Pain scores [visual analogue scale (VAS)], complications and patient satisfaction were assessed. Follow-up lasted 12 months.

There were 60 patients, 51 males and 9 females, with a mean age of 22.7 years (range 15-58). Successful treatment (complete epithelization of cyst and tracts) was documented in 55 out of the 60 patients (92% success rate). VAS pain scores were low and no major complications were recorded. Healing was achieved in 25.4 days (range 17-40) and 53.3% of patients were able to return to work the same day (the rest within 3 days). Of the failures, four patients did not heal and one patient recurred after 5 months. All failures were treated successfully with a second laser procedure except for one who denied re-intervention. Overall patient satisfaction reached 98%.

PiLaT seems to be very close to the ideal treatment of pilonidal disease, since it is safe, easy to perform, almost painless and highly effective.