Sinus Laser Closure Versus Karydakis Procedure for Treatment of Pilonidal Sinus Disease. A Prospective Study

Introduction: For general surgeons, managing pilonidal sinus disease has always been difficult. Diode laser therapy has recently become a viable alternative to traditional surgery in proctology. Relying on the strength and duration of the laser light application, the laser beam causes shrinkage and sealing of the sinus track. Additionally, it is linked to a brief hospital stay, bleeding, discharge, and little postoperative discomfort.Patients and methods: During the research period (18 months, from July 2023 to December 2024), 60 patients with pilonidal sinuses were managed prospectively at the General Surgery Department's Gastrointestinal Surgery Unit at Tanta University Hospitals. Thirty patients in Group A underwent sinus laser closure (SILAC) using a Lasotronix device, radial fibres, a wavelength of 1470 nm, and 10 watts of power. Thirty patients in Group B underwent Karydakis flap surgery.Results: Compared to Karydakis surgery in group B, which had the same risk of recurrence, sinus laser closure (SILAC) was linked to group A's reduced postoperative discomfort, increased discharge, brief hospital stay, and early resumption to regular activities.Conclusion: When compared to a karydakis flap, diode laser therapy for pilonidal sinus illness is a safe minimally invasive surgery that has a similar recurrence rate, less postoperative discomfort, and an early return to normal activities. The only drawback is its high cost.