CİĞDEM ARSLAN, EYÜP DENİZ, YAŞAR ÖZDENKAYA
Turkish Journal of Colorectal Disease - 2023;33(4):116-123
Aim: This study aimed to compare the 36-month recurrence rates between pit-picking alone and pit-picking with laser treatment (LT) in the management of pilonidal disease (PD). Method: Patients with Tezel type 3, 4, and V PD who underwent pit-picking were included in the study. All the patients underwent pit-picking; LT was added for those willing to receive the treatment. Follow-up evaluations were conducted through outpatient visits on postoperative days 3 and 10 and at 1, 6, and 12 months. Recurrence was monitored through telephone calls at 24 and 36 months. The primary outcome measure was recurrence at 36 months. Results: A total of 121 patients were included between March 2018 and October 2022; 80 underwent pit-picking only (the “pit-picking group”), and 41 were in the group that received pit-picking followed by LT (the “LT group”). The mean age was 24.5±5.9 years, and 63 (52%) patients were female. Postoperative complications were seen in 14 (11.6%) patients. Patients in the LT group had no complications, whereas the overall complication rate in the pit-picking group was 17.5% (p=0.002). The LT group had a significantly shorter return-to-work time (3.2±2.2 vs. 6.7±2.3 days, p<0.001) and “sit-pain-free time” (i.e., the time until sitting becomes painless) (5.1±2.1 vs. 7.8±3.1 days, p=0.003). The mean complete healing time was shorter in the LT group (10.1±2.3 vs. 14.1±3.8 days, p<0.001). The median follow-up was 46 (43-65) months. Thirteen (10.7%) patients had recurrence; 9 (11.3%) in the pit-picking group and 4 (9.8%) in the LT group (p=0.534). The mean time-to-recurrence was 14.7±5.6 days. Conclusion: LT when added to pit-picking does not affect mid-term recurrence rate but significantly reduces postoperative complications, pain, and workday loss.
