Comparative study of laser ablation versus conventional surgery in the management of pilonidal sinus disease

Ravindra Shankar Ghugare

doi:10.18203/2349-2902.isj20253005

Authors

Ravindra Shankar Ghugare Department of General Surgery, Ahalia Hospital Branch-1, Abudhabi, UAE

DOI:

https://doi.org/10.18203/2349-2902.isj20253005

Keywords:

Complications, Direct closure, Flap reconstruction, Surgical outcomes, Recurrence, Laser ablation, Pilonidal sinus disease

Abstract

Background: Pilonidal sinus disease (PSD) is conventionally managed through surgical excision (SE) followed by either direct closure (DC) or flap reconstruction. Laser ablation has recently been recognized as a minimally invasive alternative; however, comparative data remain limited.

Methods: This retrospective analysis involved 288 patients who received treatment for PSD at a single academic institution from 2010 to 2021.

Results: Laser treatment resulted in a significantly reduced operation time (18.2±6.8 min) and decreased sick leave duration (7.1±7.8 days) when compared to the DC and FC groups.

Conclusions: The findings indicate that laser ablation serves as a safe and also effective first-line PSD treatment, facilitating quicker recovery and reducing complications. Further long-term, randomized studies are necessary to validate its superiority.

Metrics

Metrics Loading ...

References

Sahsamanis G, Samaras S, Mitsopoulos G, Deverakis T, Dimitrakopoulos G, Pinialidis D. Semi-closed surgical technique for treatment of pilonidal sinus disease. Ann Med Surg (Lond). 2017;15:47–51. DOI: https://doi.org/10.1016/j.amsu.2017.02.004

Yardimci VH. Outcomes of two treatments for uncomplicated pilonidal Sinus disease: karydakis flap procedure and sinus tract ablation procedure using a 1,470 nm diode laser combined with pit excision. Lasers Surg Med. 2020;52(9):848–54. DOI: https://doi.org/10.1002/lsm.23224

Li Z, Jin L, Gong T, Qin K, Cui C, Wang Z, et al. An effective and considerable treatment of pilonidal sinus disease by laser ablation. Lasers Med Sci. 2023;38(1):82. DOI: https://doi.org/10.1007/s10103-023-03741-1

Huurman EA, Galema HA, de Raaff CAL, Wijnhoven BPL, Toorenvliet BR, Smeenk RM. Non-excisional techniques for the treatment of intergluteal pilonidal sinus disease: a systematic review. Tech Coloproctol. 2023;27(12):1191–200. DOI: https://doi.org/10.1007/s10151-023-02870-7

Mahmood F, Hussain A, Akingboye A. Pilonidal sinus disease: review of current practice and prospects for endoscopic treatment. Ann Med Surg. 2020;57:212. DOI: https://doi.org/10.1016/j.amsu.2020.07.050

Pronk AA, Smakman N, Furnee EJB. Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease: a randomized-controlled trial. Tech Coloproctol. 2019;23(7):665–73. DOI: https://doi.org/10.1007/s10151-019-02030-w

Nuutinen H, Savikkomaa E, Tyrväinen E. Laser treatment of pilonidal disease -immediate and mid-term results. Indian J Surg. 2023;3:87. DOI: https://doi.org/10.1007/s12262-023-03802-3

Algazar M, Zaitoun MA, Khalil OH. Sinus laser closure (SiLaC) versus Limberg flap in management of pilonidal disease: a short-term non-randomized comparative prospective study. Asian J Surg. 2022;45(1):179–83. DOI: https://doi.org/10.1016/j.asjsur.2021.04.026

Xie C, Zeng R, Yu X. Efficacy of Laser Treatment in Pilonidal Disease: A Single-Arm Meta-Analysis. Photobiomodul Photomed Laser Surg. 2024;42(5):375-82. DOI: https://doi.org/10.1089/photob.2024.0028

Qin J, Xu X, Li Z, Jin L, Wang Z, Wu J. Efficacy and safety of laser ablation for recurrent pilonidal sinus: a systematic review and meta‑analysis. Int J Colorectal Dis. 2025;40(1):47. DOI: https://doi.org/10.1007/s00384-025-04832-x

Romic I, Augustin G, Bogdanic B, Bruketa T, Moric T. Laser treatment of pilonidal disease: a systematic review. Lasers Med Sci. 2022;37(2):723–32. DOI: https://doi.org/10.1007/s10103-021-03379-x

Kalaitzis J. A New Laser-Assisted Pilonidal Sinus Excision Surgical Technique. Presentation of First 368 Cases: Short- and Mid-Term Results. Med Res Arch. 2024;12(6):78. DOI: https://doi.org/10.18103/mra.v12i6.5358

Emral AC, Gülen M, Ege B. Evaluating efficacy and outcomes: comparison of laser treatment and crystallized phenol in pilonidal sinus disease. Front Surg. 2025;11:1494382. DOI: https://doi.org/10.3389/fsurg.2024.1494382

Shrinivas K. Pilonidal Sinus Laser Assisted Closure: A New Promising Minimally Invasive Therapy. Int J Surg. 2023;5:8699.

Gülen M, Emral AC. Efficacy and Outcomes of Laser Treatment in Pilonidal Sinus Disease. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Ocak 2025;57(3):120-3. DOI: https://doi.org/10.20492/aeahtd.1535436

Karita K, Adalia L, Tuija P, Jukka H, Kethe H. Long-term follow-up of pilonidal sinus disease treated by radial laser surgery. Langenbecks Arch Surg. 2024;23(1):260. DOI: https://doi.org/10.1007/s00423-024-03455-0