A novel surgical treatment modality for pilonidal sinus using stromal cells: outcome assessment

Pilonidal sinus (PNS) is a chronic inflammatory disease that occurs in the sacrococcygeal region. It is accompanied by pain syndrome, purulent discharge, and a diminished quality of life. High recurrence rate after traditional surgeries necessitates the search for new minimally invasive treatment methods. Objective. The aim of the study is to evaluate the efficacy of a new combined surgical modality for PNS treatment using lipofilling. Materials and methods. The study included 104 patients (72 men and 32 women) aged 20–72. The patients were divided into four treatment groups: standard excision, subcutaneous sinus excision, laser coagulation (SiLaC), and a combined technique (sinus excision + SiLaC + lipofilling). The EORTC QLQ-PRT23 questionnaire was used for the subjective assessment of quality of life. Statistical processing was performed using the MS Excel 2000, Statistica 10.0, and StatPlus software packages. Results. Patients in the main group (n=35) reported no pain syndrome in 45.7 % of cases, which was statistically significantly higher compared to the results in the other groups (p≤0.05). Purulent discharge and discomfort were observed less frequently, and only 8.6 % of patients experienced fever symptoms. The surgery had little to no negative effect on daily routines (p=0.011), while satisfaction with the treatment was the most positive possible (p=0.012). Conclusion. The combined methodology, which includes subcutaneous synusectomy, SiLaC laser coagulation, and stromal cell-based lipofilling, provides an optimal balance of functional recovery, cosmetic effect, and minimal invasiveness. The use of cellular technologies accelerates healing and reduces the recurrence risk, making the approach a promising option for the PNS surgical treatment.