Department of Colorectal Surgery, University College London Hospital, London, UK.
Division of Surgery and Interventional Science, University College London, London, UK.
Tech Coloproctol. 2019 Aug;23(8):769-774. doi: 10.1007/s10151-019-02054-2. Epub 2019 Aug 9.
Haemorrhoidal disease (HD) is a common colorectal condition that often requires surgical treatment. Less invasive procedures are usually more acceptable to patients. The aim of this study was to report the outcome of a novel and minimally invasive technique employing a radiofrequency ablation (RFA) energy (Rafaelo) to treat HD.
A total number of 27 patients who had RFA for the treatment of HD were recruited to this study. The procedure was performed under deep sedation and local anaesthesia. Patients' demographics; haemorrhoid severity score (HSS); quality of life; pain and satisfaction scores; and recurrence rate were recorded.
The mean age of the patients was 46 (SD 14) years, 18 (67%) males and 9 (33%) females. The mean body mass index was 25 (SD 4) kg/m. The predominant symptom of all patients was per-rectal bleeding. HSS improved from 7.2 (SD 1.9) before the procedure to 1.6 (SD 1) after the procedure (p < 0.0001). Postoperative pain scores on a scale of 0-10 were 0, 2 (SD 2), 1 (SD 2), and 0 on immediate, day-1, day-3, and 2-month follow-up questionnaire. The mean satisfacion score was 9 (SD 1.5) out of 10 on 2-month follow-up. Mean time until patients returned to normal daily activity was 3 (SD 1) days following the procedure. Quality-of-life assessments including: visual analogue scale scores (before: mean 70, SD 23; after: mean 82, SD 16; p < 0.001) and EQ-5D-5L (before: mean 0.84, SD 0.15; after: mean 0.94, SD 0.13; p < 0.05) were significantly improved. The mean length of follow-up for recurrence of symptoms was 20 months (range 12-32 months). One patient (4%) reported the recurrence of rectal bleeding 12 months after the procedure.
RFA for the treatment of HD is safe and effective in achieving symptomatic relief. It is associated with minimal postoperative pain and low incidence of recurrence.
痔病（HD）是一种常见的肛肠疾病，通常需要手术治疗。微创程序通常更能被患者接受。本研究旨在报告一种新的微创技术的治疗效果，该技术采用射频消融（RFA）能量（Rafaelo）治疗 HD。
本研究共招募了 27 名接受 RFA 治疗 HD 的患者。该手术在深度镇静和局部麻醉下进行。记录患者的人口统计学资料；痔严重程度评分（HSS）；生活质量；疼痛和满意度评分；以及复发率。
患者的平均年龄为 46（SD 14）岁，18 名（67%）男性和 9 名（33%）女性。平均体重指数为 25（SD 4）kg/m。所有患者的主要症状均为直肠出血。HSS 从术前的 7.2（SD 1.9）改善至术后的 1.6（SD 1）（p<0.0001）。术后疼痛评分（0-10 分制）分别为 0、2（SD 2）、1（SD 2）和 2 个月随访时的 0。2 个月随访时的平均满意度评分为 9（SD 1.5）分。术后平均恢复正常日常活动的时间为 3（SD 1）天。生活质量评估包括：视觉模拟评分（术前：平均 70，SD 23；术后：平均 82，SD 16；p<0.001）和 EQ-5D-5L（术前：平均 0.84，SD 0.15；术后：平均 0.94，SD 0.13；p<0.05）均显著改善。症状复发的平均随访时间为 20 个月（12-32 个月）。1 名患者（4%）在术后 12 个月报告出现直肠出血复发。
RFA 治疗 HD 安全有效，可缓解症状。它与术后疼痛轻微和复发率低有关。
