LASER PILONIDOTOMY WITH MINIMAL ENERGY (MELPI) - MULTICENTER STUDY OF A NEW METHOD IN PILONIDAL DISEASE

Objective Laser surgery, a minimally invasive procedure for the definitive approach to Pilonidal Disease (PD), has been frequently studied in recent years. This study aims to describe a new method of pilonidectomy using minimal energy and evaluate its initial results.

Methods Retrospective multicenter study. A total of 47 consecutive patients underwent 50 minimal energy pilonidectomies (MELPi) between 2019 and 2023 at four centers in Brazil. The following factors were analyzed: age, BMI, sex, smoking, diabetes, Güner classification, disease duration, energy used, hospitalization time, complications, recurrence, wound closure, pain, and return to activities.

Results The median age was 27 years; 61.7% were men and 38.3% women. The median BMI was 25.7. Smoking was evident in 14.9% of cases, and diabetes in 2.1%. The average disease duration was 3 years. Most surgeries (36%) were performed at stage R of the disease. The median hospitalization time was 6 hours, and the median healing time was 15 days. The average energy used in the procedures was 433 joules. The median postoperative pain score was 2. Secretion occurred in 14% of cases on the 60th day. Complications (cellulitis) occurred in 4% of cases. The median time to return to work was 7 days. The average follow-up time was 12 months; recurrence occurred in 5 (10%) patients. In 3 of them, a second MELPi procedure was performed and was effective.

Conclusion MELPi presents promising initial results: low pain, low complication rates, and a rapid return to activities. It is a good option for cases of recurrence and can be performed more than once if necessary.

Keywords Pilonidal cyst, Laser surgery, Colorectal surgery, Laser ablation, Laser therapies

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Artikel online veröffentlicht:
25. April 2025