new instrumental procedure for non-prolapsing hemorrhoidal disease

Radiofrequency ablation [RFA] is a new approach for treating Grades land II hemorrhoids, in this procedure, the hemorrhoidal tissue is exposed to high frequency radio wave to, 9roduce coagulative necrosis and fixation of the vascular components of the hemorrhoids. This study reports the authors experience with this technique. The aim of this study was to determine the efficacy of RFA in the treatment of Grades/ and II hemorrhoidal disease. The present retrospective study reviews the early and long-term effects of radiofrequency ablation. A separate prospective and randomized study compared the results of radiofrequency ablation and rubber band ligation [RBL] in 60 patients with Grade II hemorrhoids in terms of their effectiveness and patient comfort. Two hundred and forty patients with Grades I and II bleeding hemorrhoids were studied. Ellman radiofrequency generator was used for this procedure. Fishers test was carried out for the statistical analysis of the outcome of the prospective study. Twenty three patients reported recurrence of bleeding, and 29 complained of pain or discomfort. The comparative study showed that though rubber band ligation was a more effective procedure [p < 0.001], the rate and severity of pain was higher [p < 0.001] than the radiofrequency coagulation. It is therefore concluded that radiofrequency ablation of hemorrhoids is easy to perform, is less painful, and has low rate of complications. It is better tolerated than RBL and can safely be repeated in case of recurrence of symptoms. It is however less efficacious

Closed anal sphincter manipulation: an alternative to anal stretch or sphincterotomy in chronic anal fissure

To assess the outcome of Closed Manipulation of the fibers of the internal anal sphincter in cases of Chronic Anal Fissures. Prospective, descriptive study from Jan. 2005 to July 2005. Setting: Gupta Nursing Home, Laxminagar, Nagpur, India. 48 patients with Chronic Anal Fissure. The patients underwent history taking, examination and investigations. Pre-operative and post-operative anal manometry was performed. Post-operative complications were noted, and early and 6-months follow-up results were recorded. Fissure healing and relief of symptoms was observed in 94% of the patients. The notable complications included ecchymosis and haematoma. A transient, variable degree of incontinence occurred in three patients. Manipulation of internal anal sphincter is an easy, safe and effective procedure for the treatment of Chronic Anal Fissure

Family practice in ano-rectal diseases

The institution of general practitioners is the backbone of healthcare system. Their competence at the core level had often averted small ailments developing into major problems. Ano-rectal disorders include a diverse group of pathologic processes that are frequently encountered in general medical practice but are seldom taken seriously. An attempt has been made in this write up to supplement family practitioners' expertise with information on advances in techniques and practices in effectively managing various ano-rectal lesions commonly encountered by them in their practice

Current treatment options for fissure-in-ano

Fissure-in-ano is a painful condition that affects a sizable majority of the population. Selecting a method of treating the condition that could achieve optimal clinical results and the least pain and inconvenience to the patient has always posed a challenge to the surgeons. This led to the innovation of a number of surgical and pharmacological methods that relax the anal muscle. While acute fissures could be managed with medical therapy alone, chronic fissures do need some form of manipulation to relieve internal sphincter spasm. materials and methods: The present study discusses various techniques advocated for the treatment of acute and chronic fissure-in-ano. It also elaborates on the advantages and deficiencies of each. discussion: Despite the initial success with pharmacological agents in the treatment of patients with chronic anal fissures, a growing concern is developing about their use. Increasing incidence of adverse effects and decreasing long-term efficacy have been the major drawbacks. Surgery still remains the preferred option which should be offered to patients with relapse or therapeutic failure with prior pharmacological treatment. Nevertheless, the patient should be informed about the pros and cons of each mode of treatment with details of cure rates and possible complications

Pilonidal sinotomy with radiofrequency

Pilonidal disease is most conveniently treated with sinotomy. A modified approach to the procedure, using radiofrequency technique, is described. The modification resulted in reduced hospital stay, less postoperative pain, early resumption to work and a reduced recurrence rate. The technique and results are described and discussed