ABSTRACT
PURPOSE: The aim of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) in the management of haemorrhoidal disease with 1 year's follow-up. METHOD: This prospective multicentre study assessed RFA (Rafaelo©) in outpatients with grade II-III haemorrhoids. RFA was performed in the operating room under locoregional or general anaesthesia. Primary endpoint was the evolution of a quality-of-life score adapted to the haemorrhoid pathology (HEMO-FISS-QoL) 3 months after surgery. Secondary endpoints were evolution of symptoms (prolapsus, bleeding, pain, itching, anal discomfort), complications, postoperative pain and medical leave. RESULTS: A total of 129 patients (69% men, median age 49 years) were operated on in 16 French centres. Median HEMO-FISS-QoL score dropped significantly from 17.4/100 to 0/100 (p < 0.0001) at 3 months. At 3 months, the rate of patients reporting bleeding (21% vs. 84%, p < 0.001), prolapse (34% vs. 91.3%, p < 0.001) and anal discomfort (0/10 vs. 5/10, p < 0.0001) decreased significantly. Median medical leave was 4 days [1-14]. Postoperative pain was 4/10, 1/10, 0/10 and 0/10 at weeks 1, 2, 3 and 4. Seven patients (5.4%) were reoperated on by haemorrhoidectomy for relapse, and three for complications. Reported complications were haemorrhage (3), dysuria (3), abscess (2), anal fissure (1), external haemorrhoidal thrombosis (10), pain requiring morphine (11). Degree of satisfaction was high (+ 5 at 3 months on a - 5/+ 5 scale). CONCLUSION: RFA is associated with an improvement in quality of life and symptoms with a good safety profile. As expected for minimally invasive surgery, postoperative pain is minor with short medical leave. CLINICAL TRIAL REGISTRATION AND DATE: Clinical trial NCT04229784 (18/01/2020).
Subject(s)
Hemorrhoidectomy , Hemorrhoids , Radiofrequency Ablation , Male , Humans , Middle Aged , Female , Hemorrhoids/surgery , Hemorrhoids/complications , Quality of Life , Hemorrhoidectomy/adverse effects , Pain, Postoperative/etiology , Radiofrequency Ablation/adverse effects , Treatment OutcomeABSTRACT
In this paper we consider a diffusive-convective model for the dynamics of a population living in a polluted environment. Threshold results are given concerning the effect of the toxicant on the living population. Some analytic results are proved and numerical experiments give suggestions in more general cases.
Subject(s)
Computer Simulation , Environmental Pollution , Models, Biological , Population Dynamics , Finite Element Analysis , Humans , Logistic ModelsABSTRACT
Cross diffusion has been widely considered in the mathematical modelling of spatially structured ecological and epidemic systems, either in the mechanical description of diffusion or in the stochastic point process description of interacting populations. In this paper mathematical results recently obtained by the authors about the asymptotic behaviour of reaction-diffusion systems with full matrices of diffusion are applied to classes of biological systems.
