Abstract
BACKGROUND: There is currently no widely accepted treatment protocol for pilonidal disease. Although surgery is often the first line of treatment, it is associated with a high recurrence rate. Noninvasive approaches to treating pilonidal disease, such as light-based epilation, have shown promise in small studies. Systematic reviews on this subject have been limited by small sample sizes, lack of comparative groups, and substantial heterogeneity. The purpose of this systematic review and meta-analysis was to address these limitations and evaluate the effectiveness of light-based epilation as an adjunct to surgery in the treatment of pilonidal disease. METHODS: A PubMed search was performed of all studies that evaluated the rate of pilonidal disease recurrence when light-based epilation was used. Only English-language comparative studies with more than 10 subjects and a follow-up longer than 6 months were included. Data from all studies were compiled, and a systematic review and meta-analysis were conducted to evaluate the effectiveness of light-based epilation in reducing pilonidal disease recurrence. RESULTS: Eleven comparative studies comprising 804 patients were included, including 3 randomized controlled trials, 4 prospective studies, and 4 retrospective studies. Light-based epilation used as an adjunct to surgery was found to significantly reduce pilonidal disease recurrence compared with surgery alone (P = 0.02). No statistically significant differences were observed when light-based epilation alone was compared with conventional treatment (P = 0.9) or surgery alone (P = 0.5). CONCLUSIONS: This study demonstrated that light-based epilation as an adjunct to surgery results in significantly lower pilonidal recurrence rates than surgery alone.