Annals of Coloproctology

Original Articles

Translational/basic research

Preclinical testing of a new radiofrequency ablation device in a porcine perianal fistula model: Sunseok Yoon, Jung-Woo Choi, Yongtaik Son, Hyun Soon Lee, Kwang Dae Hong; Ann Coloproctol. 2025;41(1):84-92. Published online February 26, 2025; DOI: https://doi.org/10.3393/ac.2024.00626.0089

1,278 View
98 Download

Abstract PDF: Purpose
Anorectal fistulas present a treatment challenge, with conventional surgical methods potentially resulting in complications such as fecal incontinence. To improve patient outcomes, more effective and minimally invasive therapies are critically needed. In this study, an optimal porcine model for the creation of anorectal fistulas was developed and used to evaluate the efficacy of radiofrequency ablation (RFA) therapy.
Methods
Two distinct but related experiments were conducted. In the first experiment, a reliable and standardized porcine anorectal fistula model was developed. In the second, the healing process was assessed, and outcomes were compared between the RFA-treated group and the control group using the established porcine model.
Results
The results indicated that a 3.5-cm fistula tract length and a 14-day evaluation period following seton removal are optimal for the porcine anorectal fistula model. In the second experiment, the RFA group tended to exhibit better outcomes regarding fistula closure, although the differences were not statistically significant. Histopathologically, no significant difference in inflammation grade was observed between groups; however, scar tissue was more predominant in the RFA group.
Conclusion
The findings suggest that RFA therapy may offer potential benefits in the treatment of anorectal fistulas, as demonstrated using a porcine model. To validate these results and explore the mechanisms of action underlying RFA therapy for anorectal fistulas, further research involving larger sample sizes and a more robust study design is required.

Anorectal benign disease

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?: Jean-Michel Didelot, Benjamin Raux, Romain Didelot, Franz Rudler, Aurelien Mulliez, Anthony Buisson, Armando Abergel, Pierre Blanc; Ann Coloproctol. 2024;40(5):481-489. Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00311.0044

4,975 View
224 Download
2 Citations

Abstract PDF

Purpose
The purpose of this study was to assess the long-term efficacy of hemorrhoidal radiofrequency thermocoagulation (RFT) on bleeding, prolapse, quality of life (QoL), and recurrence.
Methods
This retrospective, single-center study, with RFT performed using procedure modified via hemorrhoid exteriorization assessed the evolution of hemorrhoidal prolapse rated by Goligher scale; bleeding and discomfort (0–10), feeling of improvement and satisfaction (–5 to +5/5) by analog scales; the impact of hemorrhoids on QoL by HEMO-FISS-QoL score.
Results
From April 2016 to January 2021, 124 patients underwent surgery and 107 were interviewed in September 2021. The average follow-up was 30 months (range, 8–62 months). The mean work stoppage was 3 days, none in 71.0% of the cases. A mean of 4,334 J was applied. No analgesics were required for 66.4% of patients. External hemorrhoidal thrombosis was the only immediate complication in 9 patients, with no long-term reported complication. Bleeding disappeared in 53 out of 102 patients or dropped from 7 to 3 out of 10 (P<0.001). Prolapse reduced from mean grade 3 to 2 (P<0.001), discomfort from 7 to 2 out of 10 (P<0.001). HEMO-FISS-QoL score improved from 22 to 7 out of 100 (P<0.001). Feeling of improvement and overall satisfaction rate were +4/5. Recurrence occurred in 21.5% of patients at 22 months, and 6 required reoperation. Of the patients, 91.6% would choose the same procedure again and 96.3% recommend it.
Conclusion
RFT, although imperfect, leads to a significant improvement in hemorrhoidal symptoms and a lasting increase in QoL with minimal pain and downtime, high acceptance, and low complication and recurrence rates.

Citations

Citations to this article as recorded by

Quand et comment traiter des hémorroïdes
Thierry Higuero
La Presse Médicale Formation.2024; 5(1): 24. CrossRef
The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Cl
Annals of Coloproctology.2024; 40(4): 287. CrossRef

Radiofrequency ablation (Rafaelo Procedure) for the treatment of hemorrhoids: a case series in the United Kingdom: Sarah Hassan, Daniel McGrath, Richard Barnes, Simon Middleton; Ann Coloproctol. 2023;39(2):164-167. Published online August 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00276.0039

6,108 View
316 Download
5 Web of Science
8 Citations

Abstract PDF

Purpose
Hemorrhoidal disease remains a common condition that can have a significant effect on a patient’s quality of life. Various methods have been introduced over the years; however, their overall success rates remain low. Although the traditional Milligan Morgan technique is effective, the associated pain level prevents it from being an attractive form of treatment. This study was devised to assess the safety and efficacy associated with a novel minimally invasive approach, radiofrequency ablation (RFA).
Methods
Forty-two patients underwent RFA at a single center, by 1 of 2 surgeons. This was performed under local anesthetic and sedation. Outcomes including postoperative pain levels, recurrence rates, and patient satisfaction scores were recorded and analyzed using medians and interquartile ranges
Results
The median postoperative pain score was 2.5/10 (interquartile range [IQR], 0–4.5) and the overall patient satisfaction score was 9 out of 10 (IQR, 6.5–10). Recurrence rates (6–12 months following the procedure) were low at 12% and all patients reported milder symptoms at recurrence. There were no serious adverse complications
Conclusion
The results from this case series supports other limited data in concluding that RFA is a safe and effective method in the treatment of hemorrhoids and patients report a high level of satisfaction following

Citations

Citations to this article as recorded by

Latest Research Trends on the Management of Hemorrhoids
Sung Il Kang
Journal of the Anus, Rectum and Colon.2025; 9(2): 179. CrossRef
Radiofrequency Ablation for Internal Hemorrhoids: A Case Series
Kean leong Koay, Nabil Mohammad Azmi, Soma Chandrakanthan, Nurafdzillah Abdul Rahman, Diana Melissa Dualim
Cureus.2024;[Epub] CrossRef
What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?
Jean-Michel Didelot, Benjamin Raux, Romain Didelot, Franz Rudler, Aurelien Mulliez, Anthony Buisson, Armando Abergel, Pierre Blanc
Annals of Coloproctology.2024; 40(5): 481. CrossRef
Protocol for the ORION trial (RadiO fRequency ablatION for haemorrhoids): a randomised controlled trial
C. Girling, M. J. Lee, D. Vimalchandran, D. J. Jayne, S. Stancliffe, A. Wailoo, M. Bradburn, D. Hind, M. Bursnall, L. K. Robinson, S. R. Brown
Techniques in Coloproctology.2023; 27(2): 117. CrossRef
The role of the Rafaelo procedure in the management of hemorrhoidal disease: a systematic review and meta-analysis
Prokopis Christodoulou, Ioannis Baloyiannis, Konstantinos Perivoliotis, Dimitrios Symeonidis, George Tzovaras
Techniques in Coloproctology.2023; 27(2): 103. CrossRef
Radiofrequency thermocoagulation of haemorrhoids: learning curve of a novel approach
Valentin Butnari, Ahmer Mansuri, Sandeep Kaul, Veeranna Shatkar, Richard Boulton
Journal of Surgical Case Reports.2023;[Epub] CrossRef
French multicentre prospective evaluation of radiofrequency ablation in the management of haemorrhoidal disease
A. Laurain, D. Bouchard, J.-M. Rouillon, P. Petit, A. Liddo, B. Vinson Bonnet, A. Venara, J.-M. Didelot, G. Bonnaud, A. Senéjoux, T. Higuero, P. Delasalle, A.-L. Tarrerias, F. Devulder, A. Castinel, C. Thomas, H. Pillant Le Moult, C. Favreau-Weltzer, L. A
Techniques in Coloproctology.2023; 27(10): 873. CrossRef
Early and midterm results of radiofrequency ablation (Rafaelo® procedure) for third-degree haemorrhoids: a prospective, two-centre study
S. Tolksdorf, D. Tübergen, C. Vivaldi, M. Pisek, F. Klug, M. Kemmerling, H. Schäfer
Techniques in Coloproctology.2022; 26(6): 479. CrossRef

Clinical Applications of Radio-Frequency Ablation in Liver Metastasis of Colorectal Cancer: Ji Hun Gwak, Bo-Young Oh, Ryung Ah Lee, Soon Sup Chung, Kwang Ho Kim; J Korean Soc Coloproctol. 2011;27(4):202-210. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.202

4,725 View
42 Download
10 Citations

Abstract PDF

Purpose

The aim of this study is to evaluate long-term survival and prognostic factors for radio-frequency ablation (RFA) in colorectal liver metastases.

Methods

We retrospectively reviewed 35 colorectal liver metastases patients who underwent RFA between 2004 and 2008. We analyzed survival after RFA and prognostic factors for survival.

Results

Of the 35 patients, 23 patients were male and 12 were female. Their mean age was 62.40 ± 12.52 years. Mean overall survival was 38.8 ± 4.6 months, and mean progression free survival was 19.9 ± 3.4 months. Three- and 5-year overall survival rates were 42.7 ± 0.1% and 26.0 ± 0.1%, respectively. Three- and 5-year progression-free survival rates were 19.6 ± 0.1% and 4.9 ± 0.04%, respectively. Overall survival and progression-free survival were significantly improved in male and in patients with carcinoembryonic antigen (CEA) ≤ 100 ng/mL, carbohydrate antigen (CA) 19-9 ≤ 100 ng/mL, absence of extrahepatic disease, and a unilobar hepatic lesion. In addition, progression-free survival was improved in patients with a solitary hepatic lesion. On the multivariate analysis, significant survival factors were the absence of extrahepatic disease and the presence of a unilobar hepatic lesion.

Conclusion

RFA for colorectal liver metastases is an effective treatment option in male patients and in patients with CEA or CA19-9 ≤ 100, absence of extrahepatic disease, a solitary hepatic lesion, and a unilobar hepatic lesion.

Citations

Citations to this article as recorded by

The combined detection of carcinoembryonic antigen, carcinogenic antigen 125, and carcinogenic antigen 19-9 in colorectal cancer patients
Ling-Zhen Gong, Qian-Wen Wang, Jie-Wen Zhu
World Journal of Gastrointestinal Surgery.2024; 16(7): 2073. CrossRef
Microwave Ablation, Radiofrequency Ablation, Irreversible Electroporation, and Stereotactic Ablative Body Radiotherapy for Intermediate Size (3–5 cm) Unresectable Colorectal Liver Metastases: a Systematic Review and Meta-analysis
Sanne Nieuwenhuizen, Madelon Dijkstra, Robbert S. Puijk, Bart Geboers, Alette H. Ruarus, Evelien A. Schouten, Karin Nielsen, Jan J. J. de Vries, Anna M. E. Bruynzeel, Hester J. Scheffer, M. Petrousjka van den Tol, Cornelis J. A. Haasbeek, Martijn R. Meije
Current Oncology Reports.2022; 24(6): 793. CrossRef
Optimizing Loco Regional Management of Oligometastatic Colorectal Cancer: Technical Aspects and Biomarkers, Two Sides of the Same Coin
Giovanni Mauri, Lorenzo Monfardini, Andrea Garnero, Maria Giulia Zampino, Franco Orsi, Paolo Della Vigna, Guido Bonomo, Gianluca Maria Varano, Marco Busso, Carlo Gazzera, Paolo Fonio, Andrea Veltri, Marco Calandri
Cancers.2021; 13(11): 2617. CrossRef
Combined CT-guided radiofrequency ablation with systemic chemotherapy improves the survival for nasopharyngeal carcinoma with oligometastasis in liver: Propensity score matching analysis
Wang Li, Yutong Bai, Ming Wu, Lujun Shen, Feng Shi, Xuqi Sun, Caijin Lin, Boyang Chang, Changchuan Pan, Zhiwen Li, Peihong Wu
Oncotarget.2017; 8(32): 52132. CrossRef
Radiofrequency ablation in combined treatment of metastatic colorectal liver cancer
O. G. Skipenko, K. N. Petrenko, N. N. Bagmet, A. L. Bedzhanyan, L. O. Polishchuk, N. K. Chardarov, G. A. Shatveryan
Khirurgiya. Zhurnal im. N.I. Pirogova.2016; (12): 4. CrossRef
Systematic review of 12 years of thermal ablative therapies of non-resectable colorectal cancer liver metastases
Sameh Saif, Ania Z, Kielar, Matthew McInnes
International Journal of Gastrointestinal Intervention.2016; 5(1): 27. CrossRef
Evaluation of YO-PRO-1 as an early marker of apoptosis following radiofrequency ablation of colon cancer liver metastases
Sho Fujisawa, Yevgeniy Romin, Afsar Barlas, Lydia M. Petrovic, Mesruh Turkekul, Ning Fan, Ke Xu, Alessandra R. Garcia, Sebastien Monette, David S. Klimstra, Joseph P. Erinjeri, Stephen B. Solomon, Katia Manova-Todorova, Constantinos T. Sofocleous
Cytotechnology.2014; 66(2): 259. CrossRef
Clinical outcome of ultrasound-guided percutaneous microwave ablation on colorectal liver metastases
JIANBIN WANG, PING LIANG, JIE YU, MING-AN YU, FANGYI LIU, ZHIGANG CHENG, XIAOLING YU
Oncology Letters.2014; 8(1): 323. CrossRef
Efficacy and safety of thermal ablation in patients with liver metastases
Yingjun Liu, Shengping Li, Xiangbin Wan, Yi Li, Binkui Li, Yaqi Zhang, Yunfei Yuan, Yun Zheng
European Journal of Gastroenterology & Hepatology.2013; 25(4): 442. CrossRef
Gastric perforation following stereotactic body radiation therapy of hepatic metastasis from colon cancer
Matthew J. Furman, Giles F. Whalen, Shimul A. Shah, Sidney P. Kadish
Practical Radiation Oncology.2013; 3(1): 40. CrossRef

Clinical Comparison of Hepatic Resection and Radiofrequency Ablation of Hepatic Metastases from Colorectal Cancer.: Kang, Sin Jae , Park, Chi Min , Jeong, Keuk Won , Park, Sung Bae , Yun, Seong Hyeon , Chang, Weon Young , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2004;20(3):163-168.

1,088 View
5 Download

Abstract PDF: PURPOSE
The aim of this study was to compare the clinical characteristics between hepatic resection and radiofrequency ablation (RFA) in hepatic metastases of colorectal cancer.
METHODS
Among 183 patients who were diagnosed as having colorectal cancer with hepatic metastases from May 1999 to Dec. 2002, excluding 56 patients who did not undergo a hepatic resection or RFA due to multiple hepatic metastases or other distant metastases, 127 patients who were treated with a pure hepatic resection (N=68), pure RFA (N=35), or a hepatic resection with RFA (N=24) synchronous or metachronous were reviewed in this study. The study included metastatic hepatic tumor size, number, distribution, disease-free survival rate, and overall survival rate.
RESULTS
The mean hepatic tumor sizes in the resection group, the RFA group, and the resection with RFA group were 3.3 cm, 3.0 cm, and 2.5 cm, respectively, but the differences in the sizes had no statistical significance (P>0.1). In the view of the number of hepatic metastases, single metastases were the most prevalent kind in the resection group and the RFA group (64.7% and 60.0%) while multiple metastases were the most prevalent kind in the resection with RFA (20/24, 83.3%). In the resection and the RFA groups, a unilobar distribution was the most common (88.2% and 68.6%), but a bilobar distribution was the most common (87.5%) in the resection with RFA group. The disease-free survival rates were 42.2% (resection group), 30.7% (RFA group), and 22.2% (resection with RFA group) in the third year (P=0.65). The overall survival rates were 70.9% (resection group), 68.4% (RFA group), and 62.9% (resection with RFA group) in the third year (P=0.19).
CONCLUSIONS
There were no significant statistical differences in the disease-free survival and the overall survival rates between the three groups. Radiofrequency ablation (RFA) is considered as not only a complementary but also an alternative treatment tool to hepatic resection in the treatment of hepatic metastases of colorectal cancer and has a similar survival rate.

Short-term Results of Radiofrequency Ablation for Liver Metastasis of Colorectal Cancer.: Choi, Sung Il , Chang, Weon Young , Paik, Kwnag Yeool , Lee, Doo Seok , Oh, So Hyang , Kim, Jeong Han , Heo, Jin Seok , Lee, Woo Yong , Kim, Seung Hoon , Lee, Won Jae , Lim, Hyo Keun , Lim, Jae Hoon , Joh, Jae Won , Chun, Ho Kyung; J Korean Soc Coloproctol. 2002;18(1):53-58.

1,144 View
22 Download

Abstract PDF: PURPOSE
Radiofrequency ablation (RFA) is emerging as a new therapeutic method for the management of hepatic malignancy. We report our experience on the use of his technique for the management of liver metastasis of colorectal cancer.
METHODS
All 32 colorectal cancer patients with synchronous or metachronous liver metastasis treated with RFA from May 1999 to May 2001 were reviewed using retrospective method including chart review and telephone interview. All patients were followed up postoperatively to assess complications, complete necrosis, local recurrence, and survival rate.
RESULTS
Forty-one RFA sessions were performed on 70 metastatic tumors in 32 patients. There were no treatment- related death. Two complications related with RFA treatment, one intrahepatic bleeding and one intrahepatic abscess, occurred in 41 sessions of RFA (6.2%). With a median follow-up of 13.5 months, tumors recurred in 7 of 70 lesions (10.0%) from 5 patients due to incomplete necrosis and intrahepatic new lesion or distant metastasis in 13 patients of 27 patients (51.9%) after complete necrosis. There were 5 deaths and the 2 year survival rate was 80.9%. Disease free survival was 90.1%, 75%, 26.4% in 6 months, 12 months and 24 months, respectively. Seven patients underwent liver resections successfully with the application of RFA for the residual lesions in the remaining contralateral lobe. In these patients, with 9.0 months median follow up, the disease recurred in 2 patients due to incomplete necrosis, while recurring in 2 patients after complete necrosis and 3 patients were survived without recurrence or distant metastasis.
CONCLUSIONS
Radiofrequency ablation is a safe, well-tolerated, and effective treatment for liver metastasis in colorectal cancer patients. The procedure can be used to treat the residual tumor load in the contralateral lobe following liver resection in those considered unresectable at first presentation. This new therapeutic strategy seems to increase surgical resectability in patients whose mass is determined unresectable. To approve the efficacy of RFA, more long- term follow up should be attempted.

First
Prev
Page of 1
Next
Last

Search