Localization-Based Surgical Approaches in Pilonidal Sinus Treatment: A Comparative Study of Laser Therapy and Alternative Techniques.

Abstract

Background: Pilonidal sinus disease (PSD) is a chronic inflammatory condition most commonly observed in the sacrococcygeal region and predominantly affecting young individuals. Although various treatment modalities are currently employed, none has demonstrated definitive superiority, as recurrence rates-an important indicator of treatment success-remain considerable.

Objective: This study aimed to evaluate the comparative treatment success of commonly used PSD management strategies based on postoperative recurrence rates.

Methods: Patients with comparable sociodemographic characteristics were allocated into four treatment groups: microsinusectomy, surgical resection followed by phenol application, platelet-rich plasma (PRP), and laser therapy. All patients were followed for a minimum of two years. Treatment outcomes were assessed primarily in terms of postoperative recurrence.

Results: Among the evaluated modalities, laser therapy demonstrated the lowest overall recurrence rate (15.6%). However, in cases of mixed-location PSD, laser treatment was associated with the highest recurrence rate (83.3%). These findings suggest that treatment success may vary depending on anatomical localization.

Conclusion: Laser therapy may provide favorable outcomes in selected anatomical locations but appears less effective in mixed-location disease. Detailed anatomical classification should be incorporated into future studies, and outcomes should be reassessed using different laser treatment protocols to optimize patient selection and therapeutic success.