Abstract
Purpose
To describe our experience of radiofrequency thermocoagulation (RFT), assessing patient symptoms and quality of life (QoL) before and after the intervention.
Methods
Between April 2016 and April 2018, 42 outpatients were operated for internal haemorrhoids using RFT. Haemorrhoids were externalised to the anal margin and treated by using the Rafaelo® procedure, using the HPR45i probe (F-Care-Systems) under general anaesthesia. Assessment was performed prior to the intervention and during follow-up for prolapse degree using the Goligher scale; bleeding, improvement, and satisfaction using a verbal analogical scale; and the burden of haemorrhoidal disease using the HEMO-FISS-QoL questionnaire.
Results
In September 2018, 39 patients (26 males, mean age 51 [22–77]) were interviewed after an RFT intervention, during which a mean of 4.296 J was applied per patient. After a mean follow-up of 15 months, bleeding drastically decreased from 7/10 to 1/10 (p < 0.0001) and entirely stopped in 62% of patients. Prolapse significantly reduced from grade 3 to 2 (p < 0.0001) and completely disappeared in 9 out of 33 patients. Only 49% required postoperative level 2 analgesics, and 7 external thromboses were the only complication reported. Average incapacity for work was 1.72 days. All patients reported improvement of haemorrhoidal disease with a satisfaction rate mean score + 4/5. Haemorrhoidal discomfort decreased from 7/10 to 2/10 (p < 0.0001). HEMO-FISS-QoL score significantly improved, dropping from 24.91 to 5.94 (p < 0.001). Among all patients, 85% would choose RFT again if necessary and 90% would recommend it.
Conclusion
RFT treatment reduced haemorrhoidal bleeding and prolapse, and improved patient QoL.
References
Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A (2012) The prevalence of hemorrhoids in adults. Int J Color Dis 27:215–220
Abramowitz L, Benabderrahmane M, Pospait D, Philip J, Laouenan C (2014) The prevalence of proctological symptoms amongst patients who see general practitioners in France. Eur J Gen Pract 20:301–306
Tournu G, Abramowitz L, Couffignal C et al (2017) Prevalence of anal symptoms in general practice: a prospective study. BMC Fam Pract 18:78
Duben J, Hnatek L, Dudesek B, Humpolicek P, Gatek J (2013) Bipolar radiofrequency-induced thermotherapy of haemorrhoids: a new minimally invasive method for haemorrhoidal disease treatment. Early results of a pilot study. Wideochir Inne Tech Maloinwazyjne 8:43–48
Kraemer M, Kara D, Rzepisko M, Sayfan J (2015) A simple tool to evaluate common disorders: validation of a “proctological symptom scale”. Int J Color Dis 30:679–682
Abramowitz L, Bouchard D, Siproudhis L, Trompette M, Pillant H, Bord C, Senejoux CA, Favreau-Weltzer C, Berdeaux G, Zkik A (2019) Psychometric properties of a questionnaire (HEMO-FISS-QoL) to evaluate the burden associated with haemorrhoidal disease and anal fissures. Color Dis 21:48–58
Schäfer H, Tolksdorf S, Vivaldi C (2018) Radiofrequenzablation (Rafaelo®-Prozedur) zur Therapie von prolabierenden Hämorrhoiden III°. Coloproctol 40:204–210
Eddama MMR, Everson M, Renshaw S, Taj T, Boulton R, Crosbie J, Cohen CR (2019) Radiofrequency ablation for the treatment of haemorrhoidal disease: a minimally invasive and effective treatment modality. Tech Coloproctol 23:769–774
Hetzer FH, Schafer M, Demartines N, Clavien PA (2002) Prospective assessment of the learning curve and safety of stapler hemorrhoidectomy. Swiss Surg 8:31–36
Bjelanovic Z, Draskovic M, Veljovic M, Lekovic I, Karanikolas M, Stamenkovic D (2016) Transanal hemorrhoid dearterialization is a safe and effective outpatient procedure for the treatment of hemorrhoidal disease. Cir Esp 94:588–594
Altomare DF, Picciariello A, Pecorella G, Milito G, Naldini G, Amato A, Ratto C, Perinotti R, The Italian Haemorrhoid Survey Group (2018) Surgical management of haemorrhoids: an Italian survey of over 32 000 patients over 17 years. Color Dis 20:1117–1124
Emile SH, Elfeki H, Sakr A, Shalaby M (2019) Transanal hemorrhoidal dearterialization (THD) versus stapled hemorrhoidopexy (SH) in treatment of internal hemorrhoids: a systematic review and meta-analysis of randomized clinical trials. Int J Color Dis 34:1–11
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We would like to thank Florent Barascu for the photography.
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Didelot, JM., Didelot, R. Radiofrequency thermocoagulation of haemorrhoidal bundles, an alternative technique for the management of internal haemorrhoids. Int J Colorectal Dis 36, 601–604 (2021). https://doi.org/10.1007/s00384-020-03789-3
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DOI: https://doi.org/10.1007/s00384-020-03789-3