Ouali Mustapha
Proctolaser Clinic, Sfax, Tunisia.
Front Surg. 2025 Apr 25;12:1587467. doi: 10.3389/fsurg.2025.1587467. eCollection 2025.
Pilonidal sinus disease (PSD) commonly affects young adults and often requires repeated interventions with prolonged healing times. We evaluated a combined approach using Sinus Laser Ablation of the Cyst (SiLaC®) and Endoscopic Pilonidal Sinus Treatment (EPSiT®) to investigate postoperative pain, healing time, and recurrence.
This retrospective, single-center study included 83 patients (aged 15-50) treated from January 2021 to December 2023 at Proctolaser Clinic, Tunisia. Under local, regional, or general anesthesia, patients underwent endoscopic debridement (EPSiT®) followed by diode laser ablation (SiLaC®) of sinus tracts. Data on operative time, Visual Analogue Scale (VAS) pain score, healing time to complete epithelialization, recurrence, and time to return to work were collected. All patients had at least 6 months of follow-up; a subset was followed up to 1 year.
The mean operative time was 25 ± 5.4 min. Mean VAS pain score at 24 h was 1.2 ± 0.6, and 92.3% of patients resumed work or normal activities within 24 h. Mean healing time was 17.3 days, with 95% achieving complete epithelialization by 3 weeks. The overall recurrence rate at 6 months was 3.6% (3/83). Two recurrences (3.3%) occurred in patients with primary PSD, and one recurrence (4.3%) occurred in a patient with recurrent PSD. Minor infections occurred in 1.2% (1/83) of patients and resolved with oral antibiotics. Aesthetic satisfaction was high; 88% rated outcomes "excellent."
Combining SiLaC® with EPSiT® for pilonidal sinus disease appears safe and effective, featuring minimal pain, rapid return to daily activities, low recurrence, and excellent cosmetic results. A longer-term, multicenter approach is recommended to confirm durability and cost-effectiveness.
藏毛窦疾病（PSD）通常影响年轻成年人，且常常需要反复干预，愈合时间较长。我们评估了一种联合方法，即囊肿激光消融术（SiLaC®）和内镜下藏毛窦治疗术（EPSiT®），以研究术后疼痛、愈合时间和复发情况。
这项回顾性单中心研究纳入了2021年1月至2023年12月在突尼斯直肠激光诊所接受治疗的83例患者（年龄15 - 50岁）。在局部、区域或全身麻醉下，患者先接受内镜清创术（EPSiT®），随后进行窦道的二极管激光消融术（SiLaC®）。收集手术时间、视觉模拟评分（VAS）疼痛评分、完全上皮化的愈合时间、复发情况以及恢复工作时间的数据。所有患者至少随访6个月；一部分患者随访至1年。
平均手术时间为25±5.4分钟。术后24小时的平均VAS疼痛评分为1.2±0.6，92.3%的患者在24小时内恢复工作或正常活动。平均愈合时间为17.3天，95%的患者在3周内实现完全上皮化。6个月时的总体复发率为3.6%（3/83）。原发性PSD患者中有2例复发（3.3%），复发性PSD患者中有1例复发（4.3%）。1.2%（1/83）的患者发生轻微感染，通过口服抗生素治愈。美学满意度较高；88%的患者将治疗结果评为“优秀”。
将SiLaC®与EPSiT®联合用于治疗藏毛窦疾病似乎安全有效，具有疼痛轻微、快速恢复日常活动、复发率低和美容效果极佳的特点。建议采用长期的多中心研究方法来证实其持久性和成本效益。
