Pilonidal sinus destruction with a radial laser probe: technique and first Belgian experience.

BACKGROUND

The treatment of pilonidal sinus disease still remains challenging. Despite many non-surgical and surgical methods, no consensus emerged for the best treatment. We describe a new innovative technique consisting in the destruction of the pilonidal cyst with a radial laser probe (FILAC, Biolitec, Germany). The energy delivered causes the destruction of the sinus epithelium and the simultaneous obliteration of the tract.

METHOD

In December 2015, we retrospectively studied the data of our 40 first patients operated with this technique between September 2014 and September 2015. The mean follow-up period was 234 days (92-316). There were 33 men and 7 women. The mean age of the patients was 25.2 years (15-46).

RESULTS

The success rate was 87.5% (35 patients/40). Recurrence rate was 2.9% (1 patient/35). Hospital stay was 1 day for all the patients with no re-hospitalisation during the follow-up. The mean duration of soiling before healing was 18.6 days (2-35). The mean duration of pain-killers intake was 4.9 days (0-14). Four patients presented complications: 2 hematomas (5%) and 2 abscesses (5%), all medically treated.

CONCLUSION

The destruction of a pilonidal cyst with a laser probe is a safe, simple and minimally invasive technique. The success rate is good. Hospital stay is short, pain is light and complications are few as well as the number of patients needing post-operative care, allowing a rapid return to work or school. This technique could be proposed as a first-line treatment to the majority of patients with a pilonidal sinus disease.