Clinical efficacy of laser ablation and closure in the treatment of sacrococcygeal pilonidal disease and analysis of risk factors for postoperative recurrence in male patients
10.3760/cma.j.cn441530-20250805-00292
- VernacularTitle:激光消融闭合术治疗骶尾部藏毛疾病的临床效果及男性患者术后复发危险因素分析
- Author:
Zhicheng LI
1
;
Lei JIN
1
;
Zhenyi WANG
1
;
Jialin QIN
1
;
Jiong WU
1
Author Information
1. 上海中医药大学附属岳阳中西医结合医院肛肠科，上海 200437
- Publication Type:Journal Article
- Keywords:
Laser ablation closure;
Sacrococcygeal pilonidal disease;
Recurrence;
Sex hormones
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(12):1448-1454
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy and safety of laser ablation and closure for the treatment of sacrococcygeal pilonidal disease (SPD) and to analyze risk factors for postoperative recurrence in male patients.Methods:A retrospective observational study was conducted to collect clinical data of 369 patients with SPD who underwent laser ablation and closure in the Anorectal Department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine between March 2019 and December 2024. Perioperative outcomes and postoperative recurrence were analyzed. The cohort included 313 males and 56 females, with 43 patients aged ≤18 years. The median body mass index was 26.3 (IQR: 22.9, 29.6) kg/m2, and the median disease duration was 28 months (IQR: 4, 76). Among them, 218 male SPD patients who underwent surgery received preoperative sex hormone testing. A logistic regression model was used to analyze the risk factors for recurrence.Results:All patients completed the surgery. The median intraoperative ablation energy delivered was 426.8 (IQR: 243.9, 683.9) J, with no occurrence of major intraoperative complications. Postoperatively, a total of 31 patients (8.4%) required analgesic medication. Within the first postoperative week, 12 patients experienced wound oozing/bleeding; hemostasis was achieved by compression alone in 5 cases, while the remaining 7 instances required suture hemostasis after failed compression attempts. No other complications were observed. The median postoperative hospital stay was 6 (IQR: 4, 8) days, and the median time to return to regular work and life was 7 (IQR: 5, 12) days. The wound healing rate was 100%, with a median wound healing time of 35 (IQR: 30, 42) days. Postoperative recurrence occurred in 19 patients (5.1%), all of whom were male. Multivariate logistic regression analysis identified age ≤18 years (OR = 4.764, 95%CI: 2.424-34.905, P = 0.008) and a history of previous SPD surgery (OR = 5.078, 95%CI: 1.431-18.019, P = 0.012) as independent risk factors for recurrence after SPD laser ablation and closure surgery. Conclusion:Laser ablation and closure are safe, effective, and minimally invasive treatments for SPD. However, particular attention should be paid to the risk of recurrence in young male patients and those with a history of previous SPD surgery.
