Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Helsinki University Hospital, Abdominal Center, Espoo, Finland.
Langenbecks Arch Surg. 2024 Aug 23;409(1):260. doi: 10.1007/s00423-024-03455-0.
Laser ablation is one of the newest and most advanced minimally invasive techniques in treating pilonidal sinus disease (PSD). Most studies on the subject have small sample sizes and relatively short follow-up times, making evaluation of long-term healing rates and recurrences difficult. Furthermore, long-term results for laser surgery of PSD are still lacking. The aim of this study was to retrospectively report long-term follow-up results for PSD treatment by radial laser surgery.
We retrospectively studied the medical records of 83 patients who underwent the radial laser procedure for PSD between January 2017 and September 2019. Our follow-up time was a median of 5.2 years, range 1.5 to 7.4 years.
Twelve patients had a PSD recurrence after their laser procedure, which gives a recurrence rate of 14.5% (95% CI 8.2%-23.2%). These recurrences appeared at a median 12.2 months after the laser procedure, range 4.2 to 51 months. A total of 23 patients (27.7%; 95% CI 19.0-38.0) underwent a reoperation, 11 patients due to postoperative infection or prolonged recovery and 12 patients due to PSD recurrence. Recurrent PSD and spillage of pus during operation were statistically significantly associated with the need for a second operation.
Radial laser surgery provides a minimally invasive treatment option with an acceptable recurrence rate in long-term follow-up.
激光消融术是治疗藏毛窦疾病(PSD)的最新、最先进的微创技术之一。大多数关于该主题的研究样本量较小,随访时间相对较短,难以评估长期愈合率和复发率。此外,PSD 激光手术的长期结果仍然缺乏。本研究旨在回顾性报告径向激光手术治疗 PSD 的长期随访结果。
我们回顾性研究了 2017 年 1 月至 2019 年 9 月期间接受径向激光手术治疗 PSD 的 83 名患者的病历。我们的随访时间中位数为 5.2 年,范围为 1.5 至 7.4 年。
12 名患者在激光手术后出现 PSD 复发,复发率为 14.5%(95%CI8.2%-23.2%)。这些复发出现在激光手术后的中位数 12.2 个月,范围为 4.2 至 51 个月。共有 23 名患者(27.7%;95%CI19.0-38.0)需要再次手术,11 名患者因术后感染或恢复时间延长,12 名患者因 PSD 复发。术后复发 PSD 和脓液溢出与需要二次手术有统计学显著相关性。
径向激光手术为治疗 PSD 提供了一种微创治疗选择,长期随访的复发率可接受。