Sinus laser-assisted closure (SiLaC) in pilonidal sinus disease: a multicenter cohort study

Sinus laser-assisted closure (SiLaC) is gaining popularity as a minimally invasive surgical technique to treat chronic sacrococcygeal pilonidal sinus disease (SPSD). However, long-term outcomes on this technique are rarely reported in the literature. This multicenter study aimed to report the mid-term outcome of a cohort of patients who underwent SiLaC treatment for primary or recurrent SPSD.

Patients with primary or recurrent SPSD were included in this retrospective cohort study. Data were collected from medical records, and a validated questionnaire was distributed to all patients at follow-up to assess symptoms, quality of life, and the need for additional surgery.

A total of 231 patients were included, with a median follow-up of 33 months (IQR 20-44): 128 patients underwent SiLaC for primary SPSD and 103 for recurrent SPSD. Additional interventions were required in 35 patients with primary SPSD (27.3%) and in 30 patients with recurrent SPSD (29.1%). Repeat SiLaC alone, i.e. no other surgical treatment than repeat SiLaC, was performed in 25 patients (19.6%) in the primary group and 22 patients (21.4%) in the recurrent group. Treatment failure, defined as persistent symptoms and/or the need for surgery other than SiLaC, occurred in 23 patients (18.0%) in the primary group and in 21 patients (20.4%) in the recurrent group. However, SPSD-related symptoms were low at follow-up, and quality of life measured by the SF-36 was reported to be even higher than in the general USA population, both in the primary and recurrent group.

SiLaC for primary and recurrent SPSD appeared to be a safe procedure with excellent symptom control and quality of life, with only 7.8% of patients in both groups requiring other surgical treatment than SiLaC.