98 | wetenschapsdag 2023 Sessie 3c: Zing, Vecht, Huil, Bid, Lach, Werk en Bewonder x2 Auteurs J.Y. van Oostendorp, R. Schouten, R. Veldkamp, I.J.M. Han-Geurts, R.M. Smeenk Abstract titel Comparing Minimally Invasive Treatments for Pilonidal Disease: LA POPA trial (Laser And Pit-picking Or Pit-picking Alone) Background Pilonidal sinus disease (PSD) is a burdening disease with a prevalence of 26/100.000 individuals, mostly affecting young men. Conventional treatment consists of a wide array of excisional surgery techniques, often requiring multiple operations, which lead to high morbidity and medical costs. Pit-picking is a simple minimally invasive approach that can be performed in an outpatient clinic setting with local anesthesia, potentially lower costs and higher overall patient satisfaction. However, higher recurrence rates have been reported. Adjuvant laser therapy might provide a valuable option to decrease recurrence rates and improve wound healing time, but the benefit of the laser has to be established yet. The main objective of this study is to establish the efficacy of ‘pit picking with laser therapy’ versus ‘pit picking alone’ on both short and long-term outcomes. Methods The study concerns a multicenter, single-blinded, randomized, controlled, superiority trial. It will investigate the additional value of laser therapy regarding the success rate of treatment. The design involves allocation of all appropriate consecutive patients, ages 12 years or older, with primary pilonidal sinus disease to pit picking alone or combined with laser therapy. Results The primary study outcome measures the overall success rate which is defined as: closure of all pits, and the absence of symptoms, persisting sinuses or recurrence of pilonidal disease within 12 months. Secondary outcomes include wound closure time, patient experience, pain, complications, quality of life, costs and the need for revision surgery. Data collection occurs at various intervals up to 5 years post-treatment. Conclusion The LA POPA trial, as the first major trial of its kind and following the 2022 Dutch guidelines, aims to shed light on the added value of laser therapy, not just in terms of treatment efficacy but also in cost-effectiveness and patient quality of life.
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