Comparison of 3 Different Techniques in the Treatment of Pilonidal Sinus

Aim: Pilonidal sinus (Ps) is an infectious disease characterized by pain, swelling, redness and discharge. Minimally invasive interventions that allow the patient to return to daily life more easily. In this study, it was aimed to compare the surgical excision and primary suturing, liquid phenol application and laser application in Ps treatment. Materials and methods: The files of 358 patients diagnosed with Ps and operated in the years 2019-2022 were retrospectively evaluated. The patients were divided into 3 groups. Group 1 consisted of 125 patients who underwent surgical excision and primary suturing in 2019, group 2 of 194 patients who underwent liquid phenol in 2020-2021, and group 3 of 39 patients who underwent laser in 2022. The patients were evaluated at the postoperative 7th day, 1st month and 3rd month outpatient policlinic control. Results: A significant correlation was found between the groups and the development of infection (p<0.05). Infection was detected in 30.4% of those in group 1, 15.5% of those in group 2 and 10.3% of those in group 3. Recurrence was detected in 25 (20%) of 125 patients in group 1, 24 (12.2%) of 194 patients in group 2, and 3 (7.7%) of 39 patients in group 3. There was no statistically significant relationship between the groups and recurrence (p>0.05). Recurrence was seen in 14 (36.8%) of 38 patients in group 1, 18 (60%) of 30 patients in group 2, and 2 (50%) of 4 patients in group 3. A significant correlation was found between infection and recurrence (p<0.05). Recurrence is positive in 6.3% of infection-negative patients and 47.2% of infection-positive patients. Conclusion: Rapid recovery, short operative time, low complication and recurrence rates have increased the tendency for minimally invasive methods. The presence of infection may cause recurrence regardless of the method. Postoperative infection follow-up of patients is important to reduce recurrence rates.