Department of Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10 000, Zagreb, Croatia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Lasers Med Sci. 2022 Mar;37(2):723-732. doi: 10.1007/s10103-021-03379-x. Epub 2021 Jul 22.
Pilonidal disease (PD) is a common condition, and there is still an ongoing debate on ideal management that should be minimally invasive, safe, and efficient. The use of radially emitting laser in the treatment of chronic PD is a novel minimally invasive technique, and initial studies with a small number of patients showed promising results. This study aimed to assess the efficacy and safety of chronic PD treatment with a laser using a systematic review of the published literature. A systematic review was conducted after PubMed, Scopus, Embase, Web of Science, and the Cochrane database search for studies reporting laser treatment of chronic PD. Also, our unpublished prospective single-center study was included in this review. Ten of 87 studies were eligible for the review, including 971 patients. The median age of the patients was 26 (range 13-68), and the median operative time was 26 (range 6-65) min. With a median follow-up of 12 (range 7-25) months, 917 (94.4%) patients achieved primary healing with a weighted mean recurrence rate of 3.8%. The weighted mean complication rate was 10% (95% CI 5.7-14.3%, I2 = 82.28, p < 0.001), and all were minor. The published literature demonstrates that laser treatment is a promising procedure in the management of chronic PD. Furthermore, the review showed that standardized operative techniques and perioperative steps were used. The results were limited to the mild chronic PD. Classification of PD severity and standardized outcome reporting is required to define indications and contraindications for laser PD treatment. Randomized controlled trials are needed to determine the long-term effectiveness and superiority of laser treatment over other methods.
藏毛窦疾病（PD）是一种常见疾病，对于应该采用何种微创、安全且有效的治疗方法，目前仍存在争议。激光在慢性 PD 治疗中的应用是一种新颖的微创技术，初步的小样本量患者研究结果显示出良好的效果。本研究旨在通过对已发表文献的系统回顾，评估激光治疗慢性 PD 的疗效和安全性。通过对 PubMed、Scopus、Embase、Web of Science 和 Cochrane 数据库进行检索，查找关于激光治疗慢性 PD 的研究，进行系统回顾。此外，我们未发表的前瞻性单中心研究也包括在本综述中。87 项研究中有 10 项符合纳入标准，共纳入 971 例患者。患者的中位年龄为 26 岁（范围 13-68 岁），手术时间的中位数为 26 分钟（范围 6-65 分钟）。中位随访时间为 12 个月（范围 7-25 个月），917 例（94.4%）患者达到一期愈合，加权平均复发率为 3.8%。加权平均并发症发生率为 10%（95%CI 5.7-14.3%，I2=82.28，p<0.001），均为轻微并发症。已发表的文献表明，激光治疗是慢性 PD 治疗的一种有前途的方法。此外，本综述还表明，标准化的手术技术和围手术期步骤已得到应用。研究结果仅限于轻度慢性 PD。需要对 PD 的严重程度进行分类，并制定标准化的结局报告，以确定激光治疗 PD 的适应证和禁忌证。需要开展随机对照试验来确定激光治疗与其他方法相比的长期有效性和优越性。
