Postoperative Pain as a Significant Component in Evaluating Quality of Life After Surgical Treatment for Pilonidal Disease [Conference Winner Abstract]

Introduction Pilonidal disease (PD) is characterised by pain, fistula formation in the sacral region, and secretion, which can significantly disrupt daily activities and reduce overall quality of life (QoL). (1,2) Surgery is the primary treatment for PD, with a variety of techniques and their modifications being used worldwide. (3,4) Pain plays a key role in assessing a patient's QoL and is an important measure for evaluating the effectiveness of PD treatments. (5) Moreover, effective postoperative pain management is increasingly recognized as essential for ensuring successful surgical outcomes. (6,7) Aim This study aimed to compare the quality of life, with a focus on pain levels at various postoperative time points, in patients undergoing two different surgical treatments for chronic PD: minimally invasive pit-picking surgery and radical excision without suturing. Methods A total of 40 adult patients with chronic symptomatic PD were included in this study. They were divided into two groups based on the type of surgery assigned to each patient during the pre-hospital consultation: pit-picking surgery (n = 20) and radical excision (n = 20). Patients with recurrent PD were not excluded. Pain levels at the surgical site were assessed and compared using Visual Analogue Scale (VAS) at three time points: before surgery, 1 day, and 2 weeks post-surgery. In addition to pain levels, the surgical techniques were compared using the 36-Item Short Form Survey (SF-36), conducted at the same intervals. (5) Statistical analysis was conducted using the Statistical Package for the Social Sciences (SPSS, version 29.0, IBM Corp., Armonk, NY, USA). Results A total of 40 patients (100%) were available for follow-up after 2 weeks. Baseline pain levels before the procedure were not significantly different between the groups (p = 0.862), and were used to compare groups. On the first postoperative day, no significant difference in pain levels was observed between the groups, with median scores of 17.0 for the pit-picking group and 16.0 for the radical excision group (p = 0.512). However, 2 weeks post-surgery, pain levels were significantly lower in the pit-picking group compared to the radical excision group, with median scores of 2.0 and 8.0, respectively (p = 0.015). Using the SF-36, the greatest difference in QoL was observed in the physical activity domain, with median scores of 85.0 for the pit-picking group and 72.5 for the radical excision group (p = 0.027) Conclusions These short-term findings suggest that surgical treatments for PD significantly affect quality of life, particularly in the physical activity domain. However, minimally invasive pit-picking surgery appears to be a preferable option, as it is associated with less pain and a smaller overall impact on QoL.