Comparing the results of pilonidal sinus surgery under video guide with minimally invasive hook circulators with routine method

Abstract

Recent studies have suggested that the use of hook cautery has yielded positive and satisfactory short-term results. However, no reports have addressed the application of Hook's circulators for pilonidal sinus treatment in Iran. Recognizing the promising outcomes of Hook's cautery in other surgical procedures and the absence of data on its application for pilonidal sinus in Iran, this study aims to investigate the results of pilonidal sinus surgery under video guidance using minimally invasive Hook's cautery. Materials and Methods: This randomized and blinded clinical trial, conducted with ethical approval, involved 40 patients scheduled for pilonidal sinus surgery. The patients were randomly assigned to either the routine surgery or limited surgery group, and the corresponding surgical procedure was performed accordingly. The study spanned 24 weeks, with patients evaluated during in-person examinations in the second week, fourth week (telephone follow-up), fifth week (telephone follow-up), sixth week (telephone follow-up), eighth week (telephone follow-up), twelfth week (telephone follow-up), and twenty-fourth week (in-person examination) to assess the disease's status. Results: In the control group, pain intensity was significantly higher than in the intervention group at all times, except during the seventh and eighth visits (P < 0.05). Comparisons of the ability to sit revealed that only during the first (P=0.001) and second visits (P=0.009), the intervention group had significantly fewer pain-free individuals while sitting compared to the control group. Assessing the ability to walk without pain showed that only during the first visit (P=0.001) and the second visit (P=0.041), the intervention group had significantly fewer individuals walking pain-free compared to the control group. Evaluation of the need for painkillers post-surgery indicated that until the fifth visit, the intervention group required significantly fewer painkillers than the control group. Similarly, the comparison of the number of people returning to normal life until the fifth visit showed that the intervention group had significantly more individuals returning to normal life compared to the control group (P < 0.05).