Endoscopic pilonidal sinus treatment (EPSIT) versus sinus laser therapy (SiLaT) for sacrococcygeal pilonidal sinus

Introduction: New surgical treatment methods are being investigated in sacrococcygeal pilonidal sinus disease. Minimal invasive methods such as endoscopic pilonidal sinus treatment (EPSIT) and sinus laser therapy (SiLaT) have promising results and advantages of laparoscopic surgery. Aim: To compare the efficiency and safety of EPSIT with SiLaT. Material and methods: Seventy-three patients with pilonidal sinus who had undergone EPSIT or SiLaT within 2 years were evaluated retrospectively. Data of patients' demographics, complications and postoperative course were collected and compared between the two groups. Results: We analyzed seventy-three patients who underwent EPSIT or SiLaT, with a mean age of 23.4 +/- 8.4 (12-46) years and body mass index (BMI) of 25.5 +/- 4.5 (18-38) kg/m2. Among them, 36 patients (26 males, ten females) underwent EPSIT and 37 patients (27 males, ten females) underwent SiLaT. Mean operative time was similar for both groups (32.3 +/- 14.8 vs. 31.0 +/- 14.8; p = 0.757). Early complications (minimal bleeding) were recorded in 2 patients in the SiLaT group. The duration of analgesic use was significantly lower in the EPSIT group compared to the SiLaT group (1.3 +/- 0.5 (1-3) vs. 1.9 +/- 1.1 (1-5); p = 0.005). The mean postoperative time of total wound healing was similar for both groups: 23.6 +/- 14.7 (12-90) vs. 25.2 +/- 14.5 (14-90) days (p = 0.385). There was no significant difference in the average time of return to total daily activity (3.4 +/- 0.9 (2-5) vs. 3.6 +/- 1.2 (2-7) days, p = 0.679). There were no significant differences between the groups regarding late postoperative complications (recurrence: 7). Conclusions: Both methods have similar early and late complications. The duration of need for analgesic usage was shorter in EPSIT patients.