Sinus laser closure (SiLaC) versus Limberg flap in management of pilonidal disease: A short-term non-randomized comparative prospective study

Abstract

Introduction: Fistula Laser Closure (FiLAC) is a method that was originally applied in the treatment of perianal fistulas. Because of promising results, diode lasers were later on used to treat pilonidal sinus disease in a method called sinus Laser Closure (SiLaC). The aim of this study is to compare between SiLaC and Limberg flap in management of pilonidal disease.

Methods: A prospective, nonrandomized comparative study. A short-term follow-up of 71 patients with pilonidal disease was analyzed (24 operated on using the SiLaC technique and 47 using the Limberg technique). With a primary outcome is healing rate and recurrence and a secondary outcome is other measures i.e. complications, hospital stay and postoperative pain.

Results: The median operative time in the SiLaC group was 26.45 ± 5.41 min (20-35 min) and in the Limberg group 58.63 ± 7.42 min (50-75 min). In the SiLaC group, the primary healing was achieved in 23 out of 24 patients (95.8%) with a total complication rate of 20.83%. There were two cases of recurrence after initial healing in each group.

Conclusion: Sinus laser Closure (SiLaC) is comparable to Limberg flap technique in the terms of healing rate and recurrence with better outcome regarding operative time, hospital stay and post-operative pain.

Keywords: Laser therapy; Limberg flap; Pilonidal disease; Pilonidal sinus; SiLaC.