ABSTRACT
BACKGROUND: In this prospective randomized study we compared two groups of patients with grade II hemorrhoids treated with standard Rubber Band Ligation (RBL) and Combined Hemorrhoidal Radiocoagulation (CHR), respectively. METHODS: Out of 90 patients initially randomized, a total of 75 patients regularly returned to visit controls at least for 6 months of follow-up. Consequently, two groups of patients were considered: Group A, represented by 36 individuals treated with RBL, and Group B, consisting of 39 patients treated with CHR. In this study primary endpoints were determined as evaluation of the grade of pain felt immediately after the procedure and at the first evacuation (score from 1 to 10), bleeding, patient's satisfaction after 15 days and after 6 months from the treatment (score from 1 to 10), appearance of failures. RESULTS: Comparing two techniques, the mean pain score reported immediately after the procedure was 2.08 +/- 1.1 for Group A and 2.13 +/- 1.26 or Group B. At the first evacuation, the mean pain score for Group A and for Group B was 2.69 +/- 1.12 vs. 2.38 +/- 1.18, respectively. The satisfaction score during the first 15 days from the procedure was 6.61 +/- 2.35 for patients treated with RBL and 6.72 +/- 2.28 for patients who received CHR, while the mean score on overall satisfaction after 6 months was 7.11 +/- 2.11 (Group A) vs. 7.31 +/- 2.04 (Group B). At 6 months of follow-up, we observed remission of symptoms in 25 patients in Group A (69.4%) and 31 patients in Group B (79.5%). CONCLUSIONS: Satisfactory results were reported in both groups of patients after different treatments, which confirm the validity and efficacy of the two techniques used in this study. At least all patients reported positive results in terms of immediate and long-term comfort after both procedures. CHR showed better results than standard RBL, but further studies are required to evaluate the validity of these methods.
Subject(s)
Hemorrhoids/radiotherapy , Hemorrhoids/surgery , Ligation/methods , Pulsed Radiofrequency Treatment/methods , Adult , Analgesics/therapeutic use , Endpoint Determination , Female , Hemorrhage/etiology , Hemorrhage/therapy , Hemorrhoids/complications , Humans , Infant, Newborn , Male , Middle Aged , Necrosis , Pain Measurement , Patient Satisfaction , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: For early-stage hemorrhoids, in which bleeding is the primary symptom, conventional approaches to management include injection of sclerosing solutions, band ligation, and infrared coagulation. In our study, we used the radiofrequency coagulation technique as an alternative strategy to treat early-stage hemorrhoids. MATERIALS AND METHODS: A total of 210 patients with bleeding hemorrhoids were treated with radiofrequency coagulation at the Gupta Nursing Home in Nagpur, India. RESULTS: Follow-up was at 2 weeks, 3 months, and 12 months after procedure. Results were recorded as follows: (1) Bleeding--Twenty-eight (13%) patients had recurrence of bleeding during the observation period. (2) Pain--Some degree of discomfort was reported by all patients within the first 48 hours. (3) Retention of urine--Only 1 patient had retention of urine; this patient was 74 years old and had an enlarged prostate. (4) Discharge--Thirty-four (16%) patients complained of discharge in the first 2 weeks after procedure. (5) Return to work--Seventy percent (n = 145) of patients resumed their duties after 48 hours; the remainder required 1 additional day. (6) Sepsis--There were no reports of postprocedure sepsis. (7) Sphincter function--None of the patients experienced problems with continence or stenosis. Overall patient satisfaction was 84% (n = 177). CONCLUSION: Although these initial results of coagulation of hemorrhoids by radiofrequency appear quite exciting and encouraging, long-term follow-up is needed to assess the duration of relief and potential side effects. Continued work in this area will likely provide promising new dimensions in the effective management of early-stage hemorrhoids in which bleeding is the main symptom. A separate, randomized trial was carried out to assess the difference in efficacy between infrared coagulation and radiofrequency coagulation in 100 patients with early-stage hemorrhoids. Radiofrequency coagulation was found to be more effective than infrared coagulation in terms of recurrence of bleeding, asymptomatic recurrences of hemorrhoids, and overall satisfaction of technique.
Subject(s)
Blood Coagulation/radiation effects , Hemorrhoids/pathology , Hemorrhoids/radiotherapy , Adolescent , Adult , Aged , Female , Follow-Up Studies , Hemorrhage/prevention & control , Hemorrhage/radiotherapy , Humans , India , Infrared Rays/adverse effects , Infrared Rays/therapeutic use , Male , Middle Aged , Nursing Homes , Pain/etiology , Patient Satisfaction/statistics & numerical data , Radiotherapy/adverse effects , Secondary Prevention , Sepsis/etiology , Urinary Retention/etiologyABSTRACT
Use of helium-neon laser in complex treatment of patients with inflammatory processes of ano-rectal area was accompanied by anaesthetic effect and elimination of inflammation. Endoscopic laser therapy improved also colonic peristalsis.
Subject(s)
Fissure in Ano/radiotherapy , Health Resorts , Hemorrhoids/radiotherapy , Laser Therapy , Pruritus Ani/radiotherapy , Adult , Humans , Proctoscopy , UkraineABSTRACT
Les hemorroides retiennent notre attention sur deux plans: le diagnostic, ou tout notre art de medecin doits s'exercer a la recherche d'une affection generale exprimee par ce symptome, et la comprehension... (AU)
