Pilonidal sinus is a
chronic condition characterized by
inflammation, swelling, and
pain in the sacrococcygeal region. In recent years, the rate of recurrence and
wound complications in PSD remains high, and no treatment is universally accepted. This study aimed to compare the efficacy of
phenol treatment with surgical excision treatment for PSD through a meta-analysis of controlled clinical trials. We searched three electronic databases, PubMed, Embase, and Cochrane library, to comprehensively search the literature comparing
phenol treatment and surgical treatment of
pilonidal sinus. Fourteen publications were included, including five RCTs and nine non-RCTs. The
phenol group had a slightly higher rate of disease recurrence than the surgical group (RR = 1.12, 95% CI [0.77,1.63]), but the difference was not statistically significant (P = 0.55 > 0.05). As compared to the surgical group,
wound complications were considerably less common (RR = 0.40, 95% CI [0.27,0.59]).
Phenol treatment resulted in a significantly shorter operating time than surgery treatment (weighted mean difference -22.76, 95% CI [-31.13,-14.39]). The time to return to daily work was considerably shorter than in the surgical group (weighted mean difference -10.11, 95% CI [-14.58,-5.65]). Postoperative complete healing time was significantly shorter than surgical healing time (weighted mean difference -17.11, 95% CI [-32.18,-2.03]).
Phenol treatment is effective for
pilonidal sinus disease, and its recurrence rate is not significantly different from surgical treatment. The greatest advantage of
phenol treatment is the low incidence of
wound complications. Moreover, the time required for treatment and recovery are significantly lower than for surgical treatment.