WOFAPS 2025 8th World Congress of Pediatric Surgery

Maria Luisa Gaspar, Ana Isabel Barros, Catarina Carvalho, Banquart Leitão, Jorge Cagigal, Mário Rui Correia, Joana Sinde, Catarina Sousa-Lopes

centro Hospital Universitário de Santo António

Purpose: Sinus laser-assisted closure (SILAC) is an emerging, minimally invasive option for treating pilonidal sinus disease (PSD), particularly in adolescents, due to reduced pain, quicker recovery and minimal scarring. This study aims to evaluate the clinical effectiveness of SILAC for PSD in a pediatric cohort and investigate the association between laser energy levels and recurrence rates.

Method: We conducted a retrospective analysis of all pediatric patients with PSD who underwent SILAC at our tertiary center between january 2020 and december 2024. Data collected included demographics, comorbidities, disease characteristics, laser energy parameters and postoperative outcomes. Descriptive and inferential statistical analyses were conducted using SPSS version 31.0.

Results: A total of 261 patients (63.2% males and 36.8% females; mean age 15.6 ± 1.6 years) underwent SILAC. Significant comorbidities were present in 8.8% of patients. Complete healing without recurrence was achieved in 77.4% (n=175) of patients. Among patients with recurrence, 88% (n=45) required re-intervention. The recurrence rate was statistically significantly higher in males (28.2% vs 15.9%; p =0.033). The mean energy delivered was 121.7 J/cm (50-528.6 J/cm). A statistically significant association was observed between higher energy used and increased recurrence rates (p=0.008). Subgroup analysis revealed that the 101–105 J/cm subgroup had the lowest statistically significant recurrence rate (5.9%).

Conclusion: SILAC offers a safe and effective minimally invasive treatment option for pediatric pilonidal sinus disease, achieving a high rate of complete healing and an acceptable recurrence rate. Higher laser energy delivery was significantly associated with increased recurrence rates, while the 101–105 J/cm energy range demonstrated the lowest recurrence. Further studies with larger sample sizes and prospective designs are necessary to validate these findings and to establish standardized treatment protocols for pediatric pilonidal sinus disease.