Radio-ablation of advanced grades of hemorrhoids with radiofrequency

Pravin J Gupta
Current Surgery 2003, 60 (4): 452-8

BACKGROUND: For advanced degree of hemorrhoids with prolapse of the rectal mucosa, the choice is hemorrhoidectomy, which could be open, close, diathermy, Laser, or stapled one. As an effective alternative to this, in situ radio-frequency ablation of the pile mass has been found to be quite efficacious with many added advantages over the conventional hemorrhoidectomy procedures in practice.

MATERIALS AND METHODS: This study included 50 patients (34 males and 16 females) treated at Gupta Nursing Home, Laxminagar, Nagpur, India, with the above technique from April 2000 to March 2001 and each case followed up over a period of 12 months.

RESULTS: In first 4 weeks of the procedure, 14% of patients complained of bleeding, whereas all of the patients had some amount of pain. Eleven (22%) patients had serosanguinous discharge, but in none of them was there any incontinence or prolapse. All of the patients resumed their routine within 1 week of the procedure. A subsequent follow-up of the patients at an interval of 12 weeks and 12 months showed significant relief in all of the above early postoperative symptoms. During follow-up at the end of 1 year, 7 patients were found to have skin tag formation. However, complications like anal stenosis or stricture or incontinence was not found in any of the patients.

CONCLUSION: For advanced degree of piles with prolapse as the main symptom, in situ radio-frequency ablation can be a better choice to various types of hemorrhoidectomy in the sense that the hospital stay is minimized, recurrence is rare, and return to work is faster. The results are more assuring when compared with conventional hemorrhoidectomy. The technique fits into the parameters for being called the gold standard procedure. Except the radio-frequency unit, the procedure needs no specialized instrument. It can be performed in any routine surgical setup.

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