The role of radiofrequency surgery in the treatment of hemorrhoidal disease

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.