Minimal Invasive Surgical Treatment in Primary Sacrococcygeal Pilonidal Sinus Disease: Phenolization of the Sinus Tract Versus Sinus Laser Assisted Closure; Long-Term Follow-Up of a Comparative Cohort Study

BACKGROUND: No consensus has been reached on the preferred minimally invasive technique for treating primary, chronic sacrococcygeal pilonidal sinus disease. This study will compare two extensively used minimally invasive techniques: phenolization of the sinus tract and sinus laser-assisted closure.

METHODS: A comparative cohort study was conducted in two hospitals. Patients were matched on sex, age, number of sinus pits at surgery, and duration of follow-up. Patient records were examined for additional surgeries, and quality of life and symptoms were assessed with a questionnaire.

RESULTS: After a mean follow-up of 47 months, seven patients (19.4%) in the phenolization group (n = 36) required additional surgery and 11 patients (30.6%) in the SiLaC group (n = 36) underwent additional surgery. Pain as a symptom at the natal cleft was significantly lower in the phenolization group, though not clinically relevant. The question regarding general health compared to preoperatively was reported to be significantly better in the phenolization group. However, other quality of life outcomes, such as the VAS score and the SF-36, did not differ significantly between phenolization and SiLaC.

CONCLUSION: Both phenolization and sinus laser-assisted closure appear to be feasible for patients with primary SPSD, with no clear superiority of either technique.