Initial Results of the Bipolar RFITT Coagulation in Advanced Stages of Hemorrhoidal Disorder Study

Česká verzia

Authors: J. Duben; L. Hnátek; B. Dudešek; T. Musil; J. Gatěk
Authors place of work: Chirurgické oddělení Nemocnice Atlas a. s., Univerzita Tomáše Bati ve Zlíně, prim. MUDr. Jiří Gatěk, Ph. D.
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 11, s. 576-579.
Category: Monothematic special - Original

Summary

Aim of the Study:
The aim is to verify a new methodology of radiofrequency bipolar coagulation for treatment of hemorrhoids in practice.

Used Methods:
The method of bipolar radiofrequency- induced thermotherapy of internal and external hemorrhoids using the Olympus Celon apparatus. Radiofrequency bipolar electrode was applied to perform coagulation of internal and external hemorrhoids under visual control and feedback. RF energy was applied, on average, at 12 sites above the dentate line to treat internal, stage III hemorroids. In stage IV hemorrhoids, based on the prolapse extent, it was applied to external hemorrhoids, as well. In four subjects, the method was used in combination with a standard Parks management to perform excision of perianal fibromas.

Results:
From September 2007 to June 2008, the method was used in 18 patients with stage III and IV hemorrhoids. 15 patients underwent a per- protocol follow up on postoperative Day 7 and Day 21. Then, the first 5 subjects were checked in a 6- month interval and will be re-assessed in 12 months. The average duration of the procedure was 20 minutes and duration of hospitalization was 24 hours. Postoperative bleeding lasted for average 0–10 days. Major postoperative edema occured in 2 subjects. The average pain intensity (on 0-10 scale) was 1.5 on Day 7; 0.46 on Day 21. The postoperative complications included anal fissures with increased pain intensity in 2 subjects with a preoperative history of anal procedures. Transient edema of external hemorrhoids occured upon management of the stage IV hemorrhoidal disorder.

Conclusion:
Bipolar radiofrequency- induced thermotherapy of hemorrhoids is a new, semiinvasive method of the management of hemorrhoids. It is safe, with minimal rates of early postoperative complications. It is well- tolerated and evaluated by patients. Long-term results will be published further.

Key words:
hemorrhoids – radiofrequency – thermoregulation – RFITT

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