Minimally invasive treatment of pilonidal sinus disease (a systematic review and meta-analysis)

AIM: to estimate the effectiveness of minimally invasive methods for treatment of chronic inflammation in pilonidal sinus disease by systematic review.

PATIENTS AND METHODS: fifty-two clinical trials were selected from 2,576 papers in databases for systematic review. It included the following methods: the fibrin glue, the sinusectomy, the video-assisted pilonidal sinus treatment, the laser coagulation and the chemical destruction using crystallized phenol or its solution. Regarding the last two methods, a meta-analysis was carried out.

RESULTS: the meta-analysis demonstrated the high effectiveness of phenol and laser coagulation for pilonidal sinus disease. When comparing the results of phenol use and excisional techniques, there was a significant difference in higher frequency complications rate after excisional techniques (HR 0.42; 95% CI: 0.05–3.71), while the recurrence rate was the same (HR 0.98; 95% CI: 0.45–2.16). The probability of recurrence was significantly higher than after excision techniques in compare with SiLaC (HR 4.02; 95% CI: 1.13 14.3, p = 0.03). However, there was no significant differences in complication rate after SiLaC and excisional techniques (HR 0.63; 95% CI: 0.29–1.34).

CONCLUSION: the chemical destruction and laser coagulation are the most effective methods for pilonidal sinus treatment.

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