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Long-term outcomes of endoscopic minimally-invasive treatment for pilonidal sinus disease: a prospective case series with median five-year follow-up

Year: 2026

Type: article

Abstract: INTRODUCTION: Minimally-invasive endoscopic techniques for pilonidal sinus disease (PSD)-endoscopic pilonidal sinus treatment (EPSiT) and endoscopic sinus laser-assisted closure (E-SiLaC)-have shown favorable short-term outcomes, but long-term data from Asian populations are scarce. AIM: We aimed to report 5-year outcomes of EPSiT and E-SiLaC in a prospective Vietnamese cohort. MATERIALS AND METHODS: A total of 18 consecutive patients treated with EPSiT (n = 15) or E-SiLaC (n = 3) between January 2019 and December 2023 were prospectively enrolled. Treatment method was selected by shared decision-making, and all procedures were performed by a single surgeon. The patients were reviewed fortnightly until healing, then annually. The outcomes included operative time, pain (as measured by the Visual Analog Scale [VAS]), healing time, time to return to regular activities, as well as recurrence and satisfaction rates. RESULTS: . Ten participants (55.6%) had prior PSD surgery. Mean operative time was 32.5 (7.9) minutes and mean VAS score was 2.8 (1.8). Median healing time was 25 days (range, 7-45 d) and mean times to return to regular activities and to work were 7.2 (4.3) and 14.4 (9.7) days, respectively. After median follow-up of 60 months (range, 1.1-86.9 mo), 15 patients (83.3%) achieved complete healing. Recurrence was reported in 2 participants (11.1%), both in the EPSiT group and both successfully salvaged. No recurrence was recorded in the E-SiLaC group; 1 E-SiLaC case represented successful salvage of prior EPSiT failure, with sustained healing at 59 months of follow-up. All patients reported satisfaction with the achieved outcomes, and 88.9% would recommend the procedures. CONCLUSIONS: EPSiT and E-SiLaC are safe, effective, and durable options for PSD, including in patients with prior surgical failure. Larger comparative studies are warranted to confirm this finding.

Source: Videosurgery and Other Miniinvasive Techniques

DOI: 10.20452/wiitm.2026.18046