Comparative study of laser ablation versus conventional surgery in the management of pilonidal sinus disease

Background: Pilonidal sinus disease (PSD) is conventionally managed through surgical excision (SE) followed by either direct closure (DC) or flap reconstruction. Laser ablation has recently been recognized as a minimally invasive alternative; however, comparative data remain limited. Methods: This retrospective analysis involved 288 patients who received treatment for PSD at a single academic institution from 2010 to 2021. Results: Laser treatment resulted in a significantly reduced operation time (18.2±6.8 min) and decreased sick leave duration (7.1±7.8 days) when compared to the DC and FC groups. Conclusions: The findings indicate that laser ablation serves as a safe and also effective first-line PSD treatment, facilitating quicker recovery and reducing complications. Further long-term, randomized studies are necessary to validate its superiority.