Outcome of Laser Ablation in Patients Presenting With Pilonidal Sinuses at a Tertiary Care Hospital

Abstract

Pilonidal sinus disease is a chronic inflammatory condition that predominantly affects young adults and is associated with significant morbidity, prolonged recovery, and high recurrence rates when managed with conventional surgical techniques. Minimally invasive approaches such as laser ablation have emerged as promising alternatives aimed at reducing postoperative complications and improving patient recovery; however, evidence from low and middle-income countries remains limited. Objective: To evaluate the clinical outcomes, postoperative complications, and recurrence rate following laser ablation in patients presenting with primary pilonidal sinus disease at a tertiary care hospital. Methods: This descriptive observational study was conducted at the Department of Surgery, Nishtar Medical University and Hospital, Multan, over 4 months from 12 July 2025 to 12 November 2025. A total of 57 adult male patients with clinically diagnosed primary pilonidal sinus disease were enrolled using non-probability consecutive sampling. All patients underwent standardized laser ablation using a radial diode laser following mechanical curettage of the sinus tract. Demographic data, intraoperative variables, postoperative outcomes, healing time, complications, and recurrence were recorded prospectively. Follow-up assessments were conducted at 1 week, 1 month, 3 months, and 6 months. Data were analyzed using SPSS version 25. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Multivariate logistic regression was performed to identify predictors of delayed healing and recurrence. Results: The mean age of patients was 26.8 ± 6.4 years, with all participants being male. The majority had occupations involving prolonged sitting (71.9%). The mean operative time was 21.4 ± 5.2 minutes, and all procedures were performed on a day-care basis without intraoperative complications. Mean wound healing time was 4.1 ± 1.3 weeks, with complete healing within six weeks achieved in 86.0% of patients. Postoperative complications were minimal, including infection in 7.0%, seroma in 5.3%, and minor bleeding in 3.5% of cases. During a six-month follow-up, recurrence occurred in 8.8% of patients. Multivariate analysis identified tract length greater than 5 cm and intraoperative pus as significant predictors of delayed healing and recurrence. Conclusion: Laser ablation is a safe, effective, and minimally invasive treatment option for primary pilonidal sinus disease, offering rapid recovery, low complication rates, and acceptable short-term recurrence outcomes. Its adoption may represent a valuable alternative to conventional surgical techniques, particularly in resource-constrained healthcare settings.