Radiofrequency thermocoagulation of haemorrhoidal bundles, an alternative technique for the management of internal haemorrhoids

Didelot, Jean-Michel; Didelot, Romain

doi:10.1007/s00384-020-03789-3

Cited by 6 publications

(12 citation statements)

References 11 publications

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“…This study is the follow-up to the first French study conducted in 2018 on this new technique [20], extending the initial 2-year follow-up to 5 years and including 3 times more patients. The goals of this study were to assess the efficacy and safety of the Rafaelo procedure on hemorrhoidal symptoms and their maintenance in time and evaluate the rate of recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Radiofrequency hemorrhoidal treatment, excepting Ligasure (Medtronic, Dublin, Ireland) and harmonic scalpels that are nonconservative surgical techniques, has been poorly studied; therefore, this study started from limited data. At the end of the study in September 2021, the literature review of published studies using PubMed Central (keywords: "radiofrequency and hemorrhoids, " "RFITT, " "Rafaelo procedure, " "radiofrequency thermocoagulation" except Ligasure) showed publications from only 8 different centers (1 in India [26], Czech [27], Germany [28], and Russia [29] and 2 in the United Kingdom [30,31] and France [20,32]). There are no publications comparing RFT following Rafaelo procedure with other surgical techniques, but one with DGHAL and RFT combined [29].…”

Section: Discussionmentioning

confidence: 99%

“…This single-center (Clémentville Clinic, Montpellier, France), retrospective study includes all patients operated on between April 2016 and January 2021 (including the first 42 patients operated on between April 2016 and April 2018 already studied in September 2018 [20]). They represent the all-consecutive patients consulting for hemorrhoidal pathology, eligible for surgery and having opted for RFT among other proposals (Milligan-Morgan, DGHAL, or hemorrhoidopexy).…”

Section: Methodsmentioning

confidence: 99%

“…At last, a comparison was achieved between the results obtained for the first 42 patients operated on [20] and all the patients finally included.…”

Section: Methodsmentioning

confidence: 99%

“…This study was performed to determine the long-term efficacy of RFT on internal hemorrhoidal bleeding and prolapse, its impact on QoL, its feasibility in outpatient settings, the downtime and consumption of analgesics it imposes, its possible early and late complications, and its rate of recurrence. Extension of the first one performed in France in 2018 on RFT [20], it allows judging the evolution of the results obtained over time.…”

Section: Introductionmentioning

confidence: 99%

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What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?

Didelot¹,

Raux

Didelot

et al. 2022

Ann Coloproctol

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The purpose of this study was to assess the long-term efficacy of hemorrhoidal radiofrequency thermocoagulation (RFT) on bleeding, prolapse, quality of life (QoL), and recurrence. Methods: This retrospective, single-center study, with RFT performed using procedure modified via hemorrhoid exteriorization assessed the evolution of hemorrhoidal prolapse rated by Goligher scale; bleeding and discomfort (0-10), feeling of improvement and satisfaction (-5 to +5/5) by analog scales; the impact of hemorrhoids on QoL by HEMO-FISS-QoL score.Results: From April 2016 to January 2021, 124 patients underwent surgery and 107 could be interviewed in September 2021. The average follow-up was 30 months (range, 8-62 months). The mean work stoppage was 3 days, none in 71.0% of the cases. A mean of 4,334 J was applied. No analgesics were required for 66.4% of patients. External hemorrhoidal thrombosis was the only immediate complication in 9 patients, with no long-term reported complication. Bleeding disappeared in 53 out of 102 patients or dropped from 7 to 3/10 (P < 0.001). Prolapse reduced from mean grade 3 to 2 (P < 0.001), discomfort from 7 to 2/10 (P < 0.001). HEMO-FISS-QoL score improved from 22 to 7/100 (P < 0.001). Feeling of improvement and overall satisfaction rate are +4/5. Recurrence occurred in 21.5% of patients at 22 months, and 6 required reoperation. Of the patients, 91.6% would choose the same procedure again and 96.3% recommend it. Conclusion: RFT, although imperfect, leads to a significant improvement in hemorrhoidal symptoms and a lasting increase in QoL with minimal pain and downtime, high acceptance, and low complication and recurrence rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…At last, a comparison was achieved between the results obtained for the first 42 patients operated on [20] and all the patients finally included.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?

Didelot¹,

Raux

Didelot

et al. 2022

Ann Coloproctol

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Early and midterm results of radiofrequency ablation (Rafaelo® procedure) for third-degree haemorrhoids: a prospective, two-centre study

Tolksdorf

Tübergen²,

Vivaldi³

et al. 2022

Tech Coloproctol

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Background The aim of this study was to evaluate the safety and efficacy of radiofrequency ablation (RFA) for treating third degree haemorrhoids, with a follow-up over 2 years. Methods We conducted a prospective, two-centre study to assess RFA of third-degree haemorrhoids in an outpatient setting. Treatment was performed under local anaesthesia, optionally in combination with sedation. The primary endpoint was analysis of a proctological symptom score ([PSS] bleeding, itching, pain, soiling) and proctological examination to detect recurrence at 1, 6, 12 and 24 months after surgery. The secondary endpoints were postoperative complications, incidence of postoperative pain, including administration of analgesics and time to return to daily routine. Results Ninety-eight patients were included in the study. The mean age of the patients was 49.1 ± 10.9 (mean ± SD). 83 patients (84.7%) were male and 15 patients (15.3%) were female. The follow-up involved 100% (1 month), 95% (6 months), 86% (12 months) and 74% after 24 months. The individual symptom scores and overall PSS score decreased significantly in comparison to the initial score at each time point assessed. Prolapsed haemorrhoids decreased in comparison to the initial situation (100%) to 7.2% (1 month), 3.5% (6 months), 13.1% (12 months) and 13.7% (after 24 months). Thirteen patients (12.7%) required repeat haemorrhoid therapy during the 2-year follow-up period. The mean maximum pain score after the procedure was 2.5 ± 2.7 (determined with the visual analogue scale), while 33 (33.7%) patients reported having no pain. 59 (60.2%) patients did not take analgesics after the procedure. Eleven patients (11.2%) experienced minor complications (bleeding, fever, cramps, diarrhoea, anal venous thrombosis) but did not require additional treatment. Eight cases (8.2%) of major complications (infection, bleeding, severe pain) required treatment with antibiotics, a second intervention, analgesics or hospitalization. Conclusions RFA is safe and effective for treatment of third-degree haemorrhoids. The main advantages of this new method are its use on an outpatient basis under local anaesthesia, a very low level of postoperative pain and significant control of haemorrhoid symptoms over 2 years.

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The role of the Rafaelo procedure in the management of hemorrhoidal disease: a systematic review and meta-analysis

et al. 2022

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Radiofrequency thermocoagulation of haemorrhoidal bundles, an alternative technique for the management of internal haemorrhoids

Cited by 6 publications

References 11 publications

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?

Early and midterm results of radiofrequency ablation (Rafaelo® procedure) for third-degree haemorrhoids: a prospective, two-centre study

The role of the Rafaelo procedure in the management of hemorrhoidal disease: a systematic review and meta-analysis

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