Endoscopic pilonidal sinus treatment vs. laser-assisted endoscopic pilonidal sinus treatment: short-term results from a retrospective case-matched study

Abstract

Background: The aim of this study was to investigate whether the addition of laser to the endoscopic pilonidal sinus treatment (EPSIT), laser-assisted EPSIT (LEPSIT) has an effect on the method and clinical results in the treatment of pilonidal sinus disease (PSD).

Methods: Between September 2019 and September 2020, patients who underwent LEPSIT and EPSIT procedures for PSD at Bursa Medicana Hospital, Turkey, were matched for age, pit location and number, body mass index (BMI), and sex. The primary endpoint was complete wound healing and the secondary endpoints were quality of life, cosmetic results, and cost.

Results: Twenty-four LEPSIT patients were matched to 72 EPSIT patients. Eighty-one (84.4%) of the included patients were male, and the median age was 26 years (range 16-52 years). The median follow-up time was 9 months (range 3-15 months).Wound healing rates (LEPSIT; 95.8% vs. EPSIT; 93%; p = 0.99) were similar in both groups. In patients who underwent LEPSIT, the operative time (p = 0.00086) was significantly shorter, time taken to return to work (p = 0.03572) and wound closure (p < 0.00001) were significantly less. However, the time taken to return to daily activities and the percentage of wound complications were similar in both groups. The pain scores on postoperative -days 1 7, and 14 were significantly higher after EPSIT (p = 0.0083, p = 0.00054, and p = 0.0479, respectively). The postoperative analgesic requirement was significantly higher after EPSIT (p = 0.01492). The total hospital cost was significantly less in patients who underwent EPSIT (p < 0.00001). Significantly better cosmetic improvement was observed in LEPSIT procedure (p = 0.00694). First month quality of life (evaluated with the Short Form 36 Health Survey Questionnaire) was similar except for bodily pain (better after LEPSIT).

Conclusions: The success rates of LEPSIT and EPSIT are similar. LEPSIT results in better wound healing and patient comfort, and a shorter time to return to work.

Keywords: Endoscopic pilonidal sinus treatment; Fast recovery; Laser; Pilonidal sinus disease; Quality of life.