Laser treatment of pilonidal cyst in children.

BACKGROUND. The incidence of pilonidal cysts (pilonidal disease, sacrococcygeal cyst) in children and adolescents is 26 per 100,000 population. A large number of surgical techniques have been proposed for the treatment of pilonidal cysts, however, currently no "gold standard" has been chosen. Minimally invasive treatments, such us laser ablation are gaining popularity.

AIM. To evaluate the efficiency of the laser treatment of PD

MATERIALS AND METHODS. The comparative non-randomized study included 190 children with pilonidal diseases without abscess who underwent surgical treatment from 2019 to 2024. The control group consisted of 50 patients who underwent open excision with primary closure. The 1st group included 70 patients who underwent minimally invasive treatment of PD. The treatment results of patients in the control group and the 1st group were analyzed retrospectively. The prospective study included 70 patients (the 2nd group), who underwent laser treatment of the main and secondary sinus’ tracts of PD with endoscopic examination under local anesthesia.

RESULTS. The statistical analysis was performed using the StatTech 4.7.3 (developed by Stattech LLC, Russia). There were no statistically significant differences in gender, age, weight, height, BMI, surgery time, and the presence of postoperative complications in all groups. The results of treatment of patients in the main group had the advantage of a low level of postoperative pain (2±1 point; p<0.001), the least number of recurrences (abs.15.8%, 8.5% in the group; p=0.01), and no need for hospitalization. In the 1st comparison group, rapid healing of the postoperative wound was noted (14±7 days; p<0.001), but the level of postoperative pain was the highest (3.5±0.5 points; p<0.001), the longest antibacterial therapy (5±2 days; p<0.001), long-term hospitalization (6.5±2.5 days; p<0.0001), as well as the highest number of recurrences (abs. 47.4%, 28% in the group; p = 0.01). In the 2nd comparison group, the longest wound healing time was noted (31.1±3.9 days; p<0.001), a lower percentage of recurrences than in the 1st group (abs. 38.6%, in the group 21.4%; p=0.01). The size of the PC on ultrasound did not play a significant role in estimating the number of recurrences in all groups, however, it indicated a high probability of its occurrence with cyst sizes greater than 50 mm. in the group with laser treatment of PD.

CONCLUSIONS. The results are comparable with the data of the world literature. Laser treatment of PD   in children is a promising method and is characterized by a low level of recurrence, and is possible in outpatient conditions