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Session:: ePosters-Sun800-M7: Benign Anorectal

EP313 - Pilonidal Cyst Laser Extirpation (PCLE): A Single-Surgeon Retrospective Review of a Novel, Minimally Invasive Office Procedure

Sunday, May 10, 2026
9:16 AM - 9:21 AM ET

    ePoster Presenter(s)

  • Vatche J. Melkonian, DO

    Colorectal Surgery Fellow
    Cedars Sinai Medical Center
    Cedars Sinai Medical Center
    Los Angeles , CA, United States

    Disclosure information not submitted.

    • Author(s)

  • NH

    Natalie Herskovitz, n/a

    Research assistant
    n/a
    Los Angeles, California, United States

    Disclosure information not submitted.

    View ePoster

    • Senior Author(s)

  • Allen Kamrava, MD MBA FACS FASCRS

    Associate Faculty
    Cedars Sinai Medical Center
    Beverly Hills, CA, United States

    Disclosure information not submitted.

Purpose/Background: Traditional surgical excision for pilonidal disease is associated with significant patient morbidity and high recurrence rates. We aimed to evaluate the safety, efficacy, and outcomes of a novel treatment, Pilonidal Cyst Laser Extirpation (PCLE), performed predominantly in an office-based setting as a minimally invasive alternative.

Methods/Interventions: We conducted a retrospective cohort study of all 178 patients who underwent PCLE for pilonidal disease by a single surgeon between May 2017 and September 2025. The primary outcome was the overall success rate of eradicating the pilonidal cyst disease. Secondary outcomes included the overall treatment success rate stratified by prior surgical history, recurrence rate, and independent predictors of recurrence, which were identified using a multivariate logistic regression model.

Results/Outcomes: The follow-up period extended up to 6.4 years, with a mean of 201 days. Our analysis revealed that the first-pass success rate was highly dependent on prior surgical history. For the 156 patients undergoing their first surgical intervention, PCLE demonstrated a 93.6% success rate. This contrasted sharply with the 22 patients who had a history of prior failed surgery, who had a recurrence rate of 22.7%. On multivariate analysis, prior surgery was confirmed as the sole independent predictor of recurrence (Odds Ratio: 4.10, 95% CI: 1.25 – 1.345, p = 0.02). Of the 15 patients who experienced a recurrence, 14 were successfully managed with a second PCLE procedure. This resulted in an ultimate success rate of 99.4% (177/178) for the entire cohort with a maximum of two treatments. The majority of procedures (82.6%) were successfully completed in an office setting.

Conclusion/Discussion: PCLE is a highly effective office-based procedure that offers a definitive cure for pilonidal disease. For treatment-naive patients, it provides a greater than 93% chance of cure with a single, minimally invasive treatment. For the rare cases requiring a second procedure, the protocol demonstrates a high success rate. This staged, minimally invasive approach offers a superior treatment paradigm, minimizing patient morbidity and healthcare costs compared to traditional operative interventions.