SiLaT: A paradigm shift in the treatment of pilonidal disease?

Minimally invasive technique Pilonidal sinus disease Sinus laser therapy

Journal

Journal of visceral surgery
ISSN: 1878-7886
Titre abrégé: J Visc Surg
Pays: France
ID NLM: 101532664

Informations de publication

Date de publication:
06 Jun 2024
Historique:
medline: 8 6 2024
pubmed: 8 6 2024
entrez: 7 6 2024
Statut: aheadofprint

Résumé

Pilonidal disease (PD) is a common condition for which the global incidence is increasing. Surgery is the currently preferred approach to treatment but there is a growing interest in new minimally invasive techniques, such as sinus laser therapy (SiLaT). Our primary objective was to assess the efficacy of SiLaT for the treatment of pilonidal disease. The secondary objectives were to evaluate morbidity and patient satisfaction and identify predictive factors of success. All adult patients, who underwent SiLaT in our department for a primary or recurrent pilonidal sinus from June 1, 2018, to December 31, 2020, were included in the study. Healing was defined as the closure of cutaneous orifices and the absence of seepage or abscesses. In total, 111 consecutive patients, for whom the male/female sex ratio was 2.1 and the mean age 28.8 (± 9.4) years, were included in this study. Eighteen (16.2%) patients had already undergone prior surgery for PD. The mean follow-up was 339.2 (± 221.4) days. A healing rate of 78.4% was observed, with a median time to healing of 20.0 days (15.0-30.0). The median time to return to usual activities was three days (1-7). The only postoperative complication was bleeding, which occurred for two patients (1.8%). Eighty-two patients (88.2%) reported being "very satisfied" with the treatment. Multivariate analysis showed no predictive factors for healing among the studied variables. SiLaT is an efficient and safe procedure for the treatment of PD, with a high level of patient satisfaction. It will now be necessary to position it within the therapeutic algorithm.

Sections du résumé

BACKGROUND BACKGROUND
Pilonidal disease (PD) is a common condition for which the global incidence is increasing. Surgery is the currently preferred approach to treatment but there is a growing interest in new minimally invasive techniques, such as sinus laser therapy (SiLaT).
AIM OBJECTIVE
Our primary objective was to assess the efficacy of SiLaT for the treatment of pilonidal disease. The secondary objectives were to evaluate morbidity and patient satisfaction and identify predictive factors of success.
METHODS METHODS
All adult patients, who underwent SiLaT in our department for a primary or recurrent pilonidal sinus from June 1, 2018, to December 31, 2020, were included in the study. Healing was defined as the closure of cutaneous orifices and the absence of seepage or abscesses.
RESULTS RESULTS
In total, 111 consecutive patients, for whom the male/female sex ratio was 2.1 and the mean age 28.8 (± 9.4) years, were included in this study. Eighteen (16.2%) patients had already undergone prior surgery for PD. The mean follow-up was 339.2 (± 221.4) days. A healing rate of 78.4% was observed, with a median time to healing of 20.0 days (15.0-30.0). The median time to return to usual activities was three days (1-7). The only postoperative complication was bleeding, which occurred for two patients (1.8%). Eighty-two patients (88.2%) reported being "very satisfied" with the treatment. Multivariate analysis showed no predictive factors for healing among the studied variables.
CONCLUSION CONCLUSIONS
SiLaT is an efficient and safe procedure for the treatment of PD, with a high level of patient satisfaction. It will now be necessary to position it within the therapeutic algorithm.

Identifiants

pubmed: 38849230
pii: S1878-7886(24)00051-1
doi: 10.1016/j.jviscsurg.2024.03.007
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Masson SAS. All rights reserved.

Auteurs

Mélanie Draullette (M)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France. Electronic address: m.draullette@gmail.com.

Vincent de Parades (V)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Amine Antonin Alam (AA)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Nadia Fathallah (N)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Anne-Laure Rentien (AL)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Paul Benfredj (P)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Manuel Aubert (M)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Élise Pommaret (É)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Hélène Beaussier (H)

Department of Clinical Research, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Audrey Fels (A)

Department of Clinical Research, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Lucas Spindler (L)

Department of MedicoSurgical Proctology, Groupe Hospitalier Paris Saint-Joseph, Institut Léopold Bellan, 185, rue Raymond-Losserand, 75014 Paris, France.

Classifications MeSH