John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Role of radiofrequency in proctology Volume 29, issue 3, March 2022

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Authors
Groupe hospitalier Paris Saint-Joseph, Service de proctologie médicochirurgicale, 185, rue Raymond Losserand, 75014 Paris
* Correspondance : L. Valdiguié

Radiofrequency (RF) consists on the application of an electromagnetic power through a specific probe on the tissues. The only current validated indication in gastroenterology is the treatment of endobrachyoesophagus. In proctology, several indications are being evaluated. For internal hemorrhoids, RF is a minimally invasive technique. Studies have demonstrated that it permits symptomatic improvement in more than 60 %of cases with high-satisfaction and low-morbidity rates. For anal fistulas, RF is a sphincter sparing treatment. However, the rate of failure or recurrence seems to be higher than 65 %. For high-grade intraepithelial neoplasia of anus, RF could be promising with a low recurrence rate and a good tolerance. For anal incontinence, results of RF are mixed, with a decrease in incontinence scores but no significant clinical efficacy. Moreover, the effect of the treatment does not last in a long period of time, which lead to the disapprouval of this technique in this indication. For chronic hemorrhagic proctitis, results are encouraging with a decrease in bleeding and transfusions after one to two sessions of RF. To conclude, RF is at the beginning of its development in proctology and literature is still poor, but the initial results prove to be interesting in some indications. Further studies, especially comparative ones, will be necessary to better understand the results and to specify the place of RF in the therapeutic arsenal.