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. 2022;17(3):234-239.
doi: 10.5114/pg.2021.110011. Epub 2021 Oct 14.

Initial experience of radiofrequency ablation for the treatment of advanced haemorrhoidal disease

Jignesh Ashwin Gandhi  1 , Pravin Hanumant Shinde  2 , Amay Banker  2 , Sadashiv N Chaudhari  2
Affiliations

Initial experience of radiofrequency ablation for the treatment of advanced haemorrhoidal disease

Jignesh Ashwin Gandhi et al. Prz Gastroenterol. 2022.

Abstract

Introduction: The ideal approach to the management of haemorrhoidal disease (HD) remains to be elucidated. A procedure that returns the anal cushions to their normal size without destroying them or damaging the surrounding tissues is sought. Radiofrequency ablation (RFA) overcomes many of the disadvantages of the previously described repairs and may be a valuable alternative in the management of advanced HD.

Aim: To evaluate the efficacy and outcomes of the Rafaelo® technique for treatment of HD.

Material and methods: A retrospective observational study was carried out between June 2019 and October 2020. The haemorrhoidal severity score (HSS), the Cleveland Incontinence Score (CIS), and the visual analogue scale (VAS) for pain were compared prior to and post procedure using a paired t-test.

Results: Forty-seven patients were included in the study, with a mean age of 43 years. All individual symptom scores of HSS showed statistically significant improvement post RFA (p < 0.05). Minor complications like urinary retention (6.3%) and bleeding (12%) were noted. There were 2 instances of recurrence at 2 months. No major complications like anal stenosis or infections were observed.

Conclusions: The RFA technique is a safe and effective treatment alternative for advanced HD. It results in a statistically significant improvement in the symptoms of HD and is associated with minimal discomfort to the patient with early return to normal activity.

Keywords: Haemorrhoidal Severity Score; Rafaelo®; haemorrhoids; radiofrequency ablation.

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Conflict of interest statement

The Rafaelo® equipment was provided to our hospital free of cost by F Care Systems, Antwerp, Belgium. However, the authors had full control of the primary data and study design. The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Injection of local anaesthetic into the ischiorectal fat immediately peripheral to the external sphincter
Figure 2
Figure 2
A fluid barrier is created by injecting 3 ml of normal saline (NS) between the submucosa of haemorrhoidal tissue and internal anal sphincter muscle
Figure 3
Figure 3
The tip of the RFA probe is inserted into the haemorrhoidal tissue proximal to dental line, to a depth of about 5 mm, and the tissue was gently lifted up before delivering the radiofrequency current
Figure 4
Figure 4
The RF application is continued until the haemorrhoidal tissue exhibits whitish discoloration
Figure 5
Figure 5
Comparison of the haemorrhoid at 2 months following radiofrequency ablation
Figure 6
Figure 6
Mean values of Haemorrhoidal Severity Score before and 2 months after radiofrequency ablation
See this image and copyright information in PMC

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