Background: In this article we reported results obtained in our previous studies concerning application of Radiofrequency (RF) in proctology and in particular for hemorrhoids treatment. Methods: We compared Radiofrequency Sub-mucosal Hemorrhoidectomy (RSH) and Conven-tional Parks’ Hemorrhoidectomy (CPH) (group 1), Radiofrequency Open Hemorroidectomy (ROH) and Milligan-Morgan Hemorrhoidectomy (MMH)(group 2), Radiofrequency Closed Hemor-rhoidectomy (RCH) and Ferguson Hemor-rhoidectomy (FH) (group 3), Combined Hemor-rhoidal Radiocoagulation (CHR) and Rubber Band Ligation (RBL) (group 4).In this work primary endpoints were deter-mined as evaluation of the grade of pain felt im-mediately after the procedure and at the first evacuation, bleeding, operation time, readmis-sion to work, incidence of failures and patient’s satisfaction.Results: Group 1 – In comparison to Parks’ technique, use of radiofrequency scalpel reduced mean operation time (61.2 min, range 50-75, vs. 37.4 min, range 30-51; p < 0.05), first postopera-tive day pain score (5.9, range 3-10, vs. 4.0, range 1-10; p < 0.05), pain score at first evacuation (5.7, range 2-10, vs 4.2, range 1-8; p < 0.05) and pain score on postoperative days (3.6, range 1-9, vs. 2.8, range 1-8; p < 0.05). Group 2 – Results show a substantial similarity between these techniques, however the procedure lasted 7 minutes less with RF scalpel (18.6 min, range 16-21, vs. 25.55 min, range 20-30; p < 0.05). Group 3 – Patients treated with RF showed significant reduction in surgical time (23 min, range 21-31, vs. 33 min, range 24-35; p < 0.01), in pain at 1st post-operative day (VAS score 3.4 ± 1.3 vs. 4.8 ± 1.0; p < 0.05) and at the first evacuation (3.4 ± 1.0 vs. 5.0 ± 0.8; p < 0.05). Group 4 – The study confirmed validity of both the used techniques, however CHR seems to al-low a reduction in incidence of failures. Conclusions: Results obtained from radiofre-quency surgery compared with those achieved with classic surgery for hemorrhoidal disease show in the majority of cases that radiosurgery facilitates, accelerates and improves surgical procedures.

The role of radiofrequency surgery in the treatment of hemorrhoidal disease / Filingeri, V.; Bellini, M. I.; Gravante, G.. - In: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES. - ISSN 1128-3602. - 16:4(2012), pp. 548-553.

The role of radiofrequency surgery in the treatment of hemorrhoidal disease

Bellini, M. I.
Secondo
;
2012

Abstract

Background: In this article we reported results obtained in our previous studies concerning application of Radiofrequency (RF) in proctology and in particular for hemorrhoids treatment. Methods: We compared Radiofrequency Sub-mucosal Hemorrhoidectomy (RSH) and Conven-tional Parks’ Hemorrhoidectomy (CPH) (group 1), Radiofrequency Open Hemorroidectomy (ROH) and Milligan-Morgan Hemorrhoidectomy (MMH)(group 2), Radiofrequency Closed Hemor-rhoidectomy (RCH) and Ferguson Hemor-rhoidectomy (FH) (group 3), Combined Hemor-rhoidal Radiocoagulation (CHR) and Rubber Band Ligation (RBL) (group 4).In this work primary endpoints were deter-mined as evaluation of the grade of pain felt im-mediately after the procedure and at the first evacuation, bleeding, operation time, readmis-sion to work, incidence of failures and patient’s satisfaction.Results: Group 1 – In comparison to Parks’ technique, use of radiofrequency scalpel reduced mean operation time (61.2 min, range 50-75, vs. 37.4 min, range 30-51; p < 0.05), first postopera-tive day pain score (5.9, range 3-10, vs. 4.0, range 1-10; p < 0.05), pain score at first evacuation (5.7, range 2-10, vs 4.2, range 1-8; p < 0.05) and pain score on postoperative days (3.6, range 1-9, vs. 2.8, range 1-8; p < 0.05). Group 2 – Results show a substantial similarity between these techniques, however the procedure lasted 7 minutes less with RF scalpel (18.6 min, range 16-21, vs. 25.55 min, range 20-30; p < 0.05). Group 3 – Patients treated with RF showed significant reduction in surgical time (23 min, range 21-31, vs. 33 min, range 24-35; p < 0.01), in pain at 1st post-operative day (VAS score 3.4 ± 1.3 vs. 4.8 ± 1.0; p < 0.05) and at the first evacuation (3.4 ± 1.0 vs. 5.0 ± 0.8; p < 0.05). Group 4 – The study confirmed validity of both the used techniques, however CHR seems to al-low a reduction in incidence of failures. Conclusions: Results obtained from radiofre-quency surgery compared with those achieved with classic surgery for hemorrhoidal disease show in the majority of cases that radiosurgery facilitates, accelerates and improves surgical procedures.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1603452
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