Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Tech Coloproctol. 2023 Oct;27(10):921-928. doi: 10.1007/s10151-023-02831-0. Epub 2023 Jun 25.
Nowadays, surgical treatment of pilonidal sinus disease (PSD) with novel techniques is a topic of interest since conventional methods are associated with longer return to daily life and higher complication and recurrence rates. Recently, use of laser as a minimally invasive approach has become popular in the surgical treatment of PSD. In this study, we analyze the short- and mid-term results after laser treatment and the effect of endoscopic camera use on outcomes.
A total of 106 patients with PSD who underwent laser treatment between November 2017 and September 2021 were included in this study. All patients were treated with a 1470-nm diode laser. Endoscopic camera was used in 73 patients and results of these were compared with those in whom camera was not used. Follow-up period was determined as a minimum of 1 year. Data were analyzed retrospectively.
There were 80 (75%) male and 26 female patients. The median age was 26 (range 13-50) years. On the first postoperative day, 26 (26.5%) patients did not have any pain and 42(42.8%) patients reported low-grade pain. The mean time to return to daily life was 4.5 ± 5.5 (median 2, range 1-30) days. The complication rate was 10.4%. Eighty-six (87.8%) patients completely recovered and the mean complete recovery time was 27.4 ± 15.9 days. The patient satisfaction rate was 99.0%. The recurrence rate was 11.0%. Neither history of previous surgery nor abscess was associated with recurrence. Use of an endoscopic camera had no effect on postoperative pain, complete recovery, complications, patient satisfaction, and recurrence (p < 0.05).
Laser treatment for PSD is a promising approach with the advantages of less postoperative pain, early return to daily life, high patient satisfaction, and acceptable complication and recurrence rates. Nevertheless, further studies are needed to investigate the role of endoscopic camera use in this procedure since its possible advantages could not be clarified.
如今，采用新技术治疗藏毛窦疾病（PSD）是一个备受关注的话题，因为传统方法与日常生活恢复时间较长以及更高的并发症和复发率有关。最近，激光作为一种微创方法在 PSD 的外科治疗中变得流行。在这项研究中，我们分析了激光治疗后的短期和中期结果，以及使用内窥镜摄像机对结果的影响。
本研究纳入了 2017 年 11 月至 2021 年 9 月期间接受激光治疗的 106 例 PSD 患者。所有患者均接受 1470nm 二极管激光治疗。73 例患者使用内窥镜摄像机，将这些结果与未使用摄像机的结果进行比较。随访期至少为 1 年。数据进行回顾性分析。
患者中 80 例（75%）为男性，26 例为女性。中位年龄为 26 岁（范围 13-50 岁）。术后第 1 天，26 例（26.5%）患者无任何疼痛，42 例（42.8%）患者报告轻度疼痛。恢复日常生活的平均时间为 4.5±5.5 天（中位数 2 天，范围 1-30 天）。并发症发生率为 10.4%。86 例（87.8%）患者完全康复，平均完全康复时间为 27.4±15.9 天。患者满意度为 99.0%。复发率为 11.0%。既往手术史和脓肿均与复发无关。使用内窥镜摄像机对术后疼痛、完全康复、并发症、患者满意度和复发均无影响（p＜0.05）。
激光治疗 PSD 是一种很有前途的方法，具有术后疼痛较轻、日常生活恢复较早、患者满意度高以及并发症和复发率可接受等优点。然而，需要进一步研究内窥镜摄像机在该手术中的作用，因为其可能的优势尚不清楚。
