Does the holmium laser have a place in the treatment of pilonidal cysts? (Pilolas study).

Autor: Darnis B; Clinique de La Sauvegarde, Lyon, France. darnis@chirurgien-digestif.com., Blanchet MC; Clinique de La Sauvegarde, Lyon, France., Buiron C; Clinique de La Sauvegarde, Lyon, France., Crozet J; Clinique de La Sauvegarde, Lyon, France., Duchamp C; Clinique de La Sauvegarde, Lyon, France., Frering V; Clinique de La Sauvegarde, Lyon, France., Gignoux B; Clinique de La Sauvegarde, Lyon, France.
Jazyk: angličtina
Zdroj: Lasers in medical science [Lasers Med Sci] 2024 Nov 23; Vol. 39 (1), pp. 287. Date of Electronic Publication: 2024 Nov 23.
DOI: 10.1007/s10103-024-04239-0
Abstrakt: Recently, a minimally invasive procedure based on a laser technique (SiLaT) has been developed for the treatment of pilonidal cysts. Although less invasive and less painful than surgery, this solution is nevertheless limited by its high cost. Other more affordable laser devices, such as the holmium laser, are also used in minimally invasive surgery. The objective of this study was to evaluate the possibility of using the holmium laser instead of the SiLaT laser in the treatment of pilonidal cysts. Retrospective cohort study with the primary endpoint being the cure rate one month after treatment. Median duration of local care was 21 days (mean = 22 ± 7.5) and healing rate at 1 month was 90.7%. During follow-up, 102 patients (44.9%) experienced pain in the coccygeal region often exacerbated by sitting and significantly more common in people with a small frame, overwhelmingly female. A surgical site infection was reported in 36 patients (15.9%). Recurrence, occurred in 39 patients (17.2%), was related to cyst type (type 1 do not recur, type 3 recur twice three time than type 2). Holmium laser does not differ from SiLaT laser in the healing rate of pilonidal cysts after treatment. However, it is characterised by a moderately higher incidence of complications, foremost of which is the occurrence of pain that can persist for up to a year after the procedure and which could be related to an increase in heat inherent to the use of holmium. As a result, this procedure does not seem to represent an alternative to SiLaT.
Competing Interests: Declarations. Conflict of Interest: This study was funded by the Groupement de coopération sanitaire Ramsay Santé pour l’Enseignement et la Recherche. The authors have no competing interests to declare that are relevant to the content of this article. Ethical Statement: The protocol for this study was approved by the IRB (Institutional Review Board) of the Groupement de coopération sanitaire Ramsay Santé pour l’Éducation et la recherche. Given the retrospective nature of the study, all the procedures performed were part of the routine care. Informed Consent: Informed consent was not required for this retrospective study according to the principles of ethics in medical research. However an information letter was sent to all patients. None of them objected to the use of their anonymized data for this study.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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