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Background <p>This retrospective study aimed to evaluate the efficacy, safety, and patient-reported long-term results of a minimally invasive method of diode laser ablation combined with pit excision for pilonidal sinus disease, reveal predictive factors affecting treatment success, and quantitatively examine patient satisfaction and quality of life dimensions.</p> Methods <p>Fifty-four adults were treated consecutively, and the primary analysis included 39 patients who 6month patientreported outcomes (PROs: QoR15, SAPS, PROMIS Global10) assessed by an independent investigator. The primary endpoints were recurrence and treatment success (no recurrence without re-intervention). Delayed healing was a composite of epithelialization &gt; 30 days or discharge &gt; 14 days. Exploratory subgroup analyses (sex and BMI) reported effect sizes with Benjamini–Hochberg–adjusted qvalues. Receiver operating characteristic (ROC) curve analysis assessed PRO discrimination for recurrence with 95% confidence intervals (CIs).</p> Results <p>Mean followup was 13.6 ± 3.6 months; treatment success 84.6% (33/39), recurrence 15.4% (6/39), and delayed healing 20.5% (8/39). Mean PROs were: QoR15 136.8 ± 19.9, SAPS 30.4 ± 4.3, PROMIS 46.2 ± 6.8; early postoperative pain (VAS) 1.9 ± 1.3. QoR15, SAPS, and PROMIS correlated inversely with recurrence (<i>r</i> = − 0.46 to − 0.36; all <i>p</i> &lt; 0.05) and showed AUCs of 0.79 (95% CI 0.65–0.93), 0.73 (0.58–0.88), and 0.70 (0.54–0.86), respectively. Age was associated with a longer recovery time (<i>p</i> = 0.002). No material differences in PROs by sex or BMI were observed after multiplicity control.</p> Conclusions <p>In this single-center consecutive cohort, combined diode laser ablation with a pit excision technique was associated with short perioperative timelines, high patient-reported recovery/satisfaction, and acceptable mid-term recurrence, whereas PRO scores demonstrated fair discrimination for recurrence. Findings should be interpreted cautiously given the retrospective design and modest sample size; prospective, adequately powered studies are needed to validate the prognostic performance and comparative effectiveness.</p>

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Combined laser ablation and pit excision for pilonidal sinus: effectiveness, quality of recovery, and patient-reported outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月28日

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  • Alp Omer Canturk,
  • Enis Dikicier,
  • Erhan Eroz,
  • Bahaeddin Umur Aka,
  • Elif Tutar,
  • Umit Soydas,
  • Fatih Altintoprak

摘要

Background

This retrospective study aimed to evaluate the efficacy, safety, and patient-reported long-term results of a minimally invasive method of diode laser ablation combined with pit excision for pilonidal sinus disease, reveal predictive factors affecting treatment success, and quantitatively examine patient satisfaction and quality of life dimensions.

Methods

Fifty-four adults were treated consecutively, and the primary analysis included 39 patients who 6month patientreported outcomes (PROs: QoR15, SAPS, PROMIS Global10) assessed by an independent investigator. The primary endpoints were recurrence and treatment success (no recurrence without re-intervention). Delayed healing was a composite of epithelialization > 30 days or discharge > 14 days. Exploratory subgroup analyses (sex and BMI) reported effect sizes with Benjamini–Hochberg–adjusted qvalues. Receiver operating characteristic (ROC) curve analysis assessed PRO discrimination for recurrence with 95% confidence intervals (CIs).

Results

Mean followup was 13.6 ± 3.6 months; treatment success 84.6% (33/39), recurrence 15.4% (6/39), and delayed healing 20.5% (8/39). Mean PROs were: QoR15 136.8 ± 19.9, SAPS 30.4 ± 4.3, PROMIS 46.2 ± 6.8; early postoperative pain (VAS) 1.9 ± 1.3. QoR15, SAPS, and PROMIS correlated inversely with recurrence (r = − 0.46 to − 0.36; all p < 0.05) and showed AUCs of 0.79 (95% CI 0.65–0.93), 0.73 (0.58–0.88), and 0.70 (0.54–0.86), respectively. Age was associated with a longer recovery time (p = 0.002). No material differences in PROs by sex or BMI were observed after multiplicity control.

Conclusions

In this single-center consecutive cohort, combined diode laser ablation with a pit excision technique was associated with short perioperative timelines, high patient-reported recovery/satisfaction, and acceptable mid-term recurrence, whereas PRO scores demonstrated fair discrimination for recurrence. Findings should be interpreted cautiously given the retrospective design and modest sample size; prospective, adequately powered studies are needed to validate the prognostic performance and comparative effectiveness.