Multicentrique Prospective Evaluation of Radiofrequency Surgical Treatment of Homorrhoidal Disease (RF-GREP)

Ramsay Générale de Santé

Status: Unknown

Conditions: Surgical Procedure, Unspecified; Hemorrhoids

Treatments: Procedure: Radiofrewuency surgery

Study type: Interventional

Funder types: Other

Identifiers

NCT04229784

2018-A03220-55

Details and patient eligibility

About

Hemorrhoids consist of a tissue rich in blood vessels and are present in all individuals inside the anus. Hemorrhoidal disease (HD) is when hemorrhoids become troublesome and cause symptoms such as pain, bleeding, prolapse or seepage.

The first steps in the treatment of HD involve either drugs or instrumental gestures (sclerosis, ligation). In the event of failure or of a disease that is significant from the outset, it is possible to envisage a surgical treatment.

The use of a radiofrequency is a new technique, already used frequently by vascular surgeons in the treatment of varicose veins of the lower limbs. This technique has been developed for radiofrequency destruction of hemorrhoidal vascular tissue.

In France, no studies have been carried out to evaluate this new technique.

Full description

Hemorrhoids consist of a tissue rich in blood vessels and are present in all individuals inside the anus (internal hemorrhoids). Hemorrhoidal disease (HD) is when hemorrhoids become troublesome and cause symptoms such as pain, bleeding, prolapse or seepage.

The first steps in the treatment of HD involve either drugs or instrumental gestures (sclerosis, ligation). In the event of failure or of a disease that is significant from the outset, it is possible to envisage a surgical treatment.

The use of a radiofrequency current (Rafaelo technique) in the treatment of hemorrhoidal disease is a new technique, already used frequently by vascular surgeons in the treatment of varicose veins of the lower limbs. This technique has been developed for radiofrequency destruction of hemorrhoidal vascular tissue.

Although radiofrequency destruction of hemorrhoidal vascular tissue is already used in other European countries such as Poland, Germany, Belgium and Great Britain, there are very few studies on this minimally invasive surgical technique. This is particularly the case in France where no studies have been carried out to evaluate this new technique.

Enrollment: 150 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female consultant for a grade II or III haemorrhoidal pathology after failure of medical-instrumental treatments.
• Age > 18 years old and < 75 years old
• Patient having signed an informed consent
• Affiliate or beneficiary of a social security scheme
• For patients taking anti-vitamin K (AVK) or oral anticoagulants (OACs) a short stop will be recommended according to HAS recommendations.
• For patients on antiplatelet agents (APA), the relay and stopping procedures will be carried out according to the current recommendations of the HAS (26)
• Patient eligible to be an outpatient

Exclusion criteria

• Patient with IBD (inflammatory bowel diseases)
• Patient with haematological disease at risk of bleeding
• Patient with anal fistulas
• Patient unable to interrupt VKAs, OACs or APAs.
• Patient with an associated anal fissure
• External hemorrhoidal pathology
• Patient participating in another clinical study
• Pregnant or lactating women
• Patient with pacemaker or implantable defibrillator
• Protected patient: adult under guardianship, trusteeship or other legal protection, deprived of liberty by judicial or administrative decision

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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150 participants in 1 patient group

RF ARM

Experimental group

Description:

The research procedure consists of radiofrequency destruction of hemorrhoidal vascular tissue. It consists in delivering a 4 MHz radiofrequency wave current delivered at low temperature by microfibre electrodes using a large disposable needle within the hemorrhoidal vascular tissue

Treatment:

Procedure: Radiofrewuency surgery