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.