Laser versus rhomboid flap for sacrococcygeal pilonidal sinus: multi-centre comparative study

Area of Science:

• Surgical outcomes
• Pilonidal sinus management
• Minimally invasive surgery

Background:

• Pilonidal sinus affects young individuals, with various treatment options available.
• Laser ablation and open techniques are common surgical approaches.
• Assessing recurrence rates is crucial for treatment efficacy.

Purpose of the Study:

• To compare the recurrence rates of pilonidal sinus treated with laser ablation versus open techniques.
• To evaluate the long-term outcomes of these two popular surgical methods.

Main Methods:

• A comparative study conducted in government and private hospitals.
• Inclusion criteria: Pilonidal sinus diagnosis, age 16-70, no prior surgery.
• Exclusion criteria: Diabetes, immune deficiency, age outside range.
• 190 patients in the laser group and 184 in the open group.
• Follow-up for 4 weeks to 3 months.

Main Results:

• No significant differences in age, BMI, or obesity between groups.
• Laser ablation group demonstrated a significantly higher recurrence rate (p < 0.00001).
• Open rhomboid flap technique showed a lower recurrence rate.
• Single-opening pilonidal sinus had better outcomes with laser, but no significant difference in the open group.

Conclusions:

• Laser ablation for pilonidal sinus is associated with a higher recurrence rate compared to the open rhomboid flap technique.
• The open rhomboid flap technique appears more effective in reducing pilonidal sinus recurrence.
• Treatment choice may depend on disease complexity, with single openings potentially favoring laser outcomes.