Comparison of PiLAT procedure and Crystallized Phenol Application in Pilonidal Sinus Surgery

Abstract

Background: Pilonidal sinus disease (PSD) is an infectious, chronic and benign disorder of the sacrococcygeal area, predominantly encountered in young men. The surgical treatment of PSD has a wide range from minimally invasive interventions to complex flap techniques, however there is no agreement on the surgical approach. Minimally invasive procedures such as crystallized phenol (CP) application, sinusectomy, and pilonidal sinus tract ablation with laser (PiLAT) are easily applied, need a short hospital stay, cause less postoperative pain and minimal tissue loss, and have good cosmetic results. In this study, we aimed to compare the data of PSD patients treated with minimally invasive methods, namely CP and PiLAT. Material and Methods: The files of 245 PSD patients who were treated with the CP or PiLAT in our clinic between January 2016 and January 2020 were retrospectively reviewed. The patients were divided into two groups: 120 patients in the CP group and 125 patients in the PiLAT group. Both group were analyzed for age, gender, the number of sinuses, duration of surgery, severity of postoperative pain and need for analgesics, duration of antibiotic use, postoperative complications (infection, hematoma, seroma, cosmetic), time to return to daily activities, satisfaction for procedure, body mass index (BMI) and recurrence rates. Results: The patients in the PiLAT group were discharged the next day after the procedure, while the patients in the CP group discharged on the same day (p<0.001). The mean number of sinuses was 2.2 ± 0.25 in the CP group and 3.6 ± 0.81 in the PiLAT group, and the difference was statistically significant (p<0.001). The mean dressing time was 3.1 ± 0.4 days in the PiLAT group, while it was longer, 9.5 ± 2.1 days, in the CP group (p <0.001). Conclusion: CP and PiLAT procedures are minimally invasive methods that can be safely used in the treatment of PSD. Keywords: Crystallized phenol, Minimally invasive, PiLAT, Pilonidal sinüs disease, Surgery