The Efficacy of Punch Biopsy and Diode Laser Combination in the Treatment of Pilonidal Sinus: A Comparative Study Across Different Patient Groups.

Background: This study aims to evaluate the efficacy and safety of a minimally invasive technique (pit excision with a punch biopsy needle) using a 1470 nm diode laser in the treatment of pilonidal sinus disease. Methods: A prospective study conducted included 187 patients who underwent laser treatment for pilonidal sinus. Patients were divided into two groups based on the severity of the disease: Group 1 (simple group) included patients who had no prior abscess formation and had one or two sinus openings, while Group 2 (complicated group) comprised patients with a history of abscess drainage and more two extensive sinus openings. The surgical procedure was performed under local anesthesia. The sinus openings were excised using a punch biopsy needle and subsequently closed with a diode laser probe. Patients were followed up at regular intervals during the postoperative period. Results: The findings revealed that the operative time (12.22 ± 1.72 min), postoperative pain scores and wound-healing duration were significantly lower in the simple group compared to the complicated group (p < 0.001). The recurrence rates were 3.7% in the simple group and 14.1% in the complicated group. The return-to-work time was 1.06 ± 0.32 days in the simple group and 1.32 ± 0.90 days in the complicated group. Conclusions: In conclusion, the combination of punch biopsy and diode laser is considered a safe and effective method, particularly for simple pilonidal sinus cases, due to its low complication rates, short recovery time, and early return-to-work advantages. However, more advanced treatment approaches are required for complicated cases.