Treatment of rectal prolapse with radiofrequency ablation and plication--a new surgical technique.

BACKGROUND: This study was designed to assess the outcome of using a new technique of mucosal ablation using a radiofrequency device followed by its plication for rectal mucosal prolapse and to compare its results with the conventional ligature and excision procedure.

MATERIALS AND METHODS: The procedure of radiofrequency ablation and mucosal plication (RAMP) is described. A Ellman radiofrequency generator was used for the procedure. Out of the 46 patients with rectal mucosal prolapse, 24 patients were randomized to undergo ligature and excision procedure (LEP) and 22 were operated with RAMP. The operating time, amount of pain (VAS scale), postoperative analgesic requirement, time to return to work, wound healing period and postoperative complications were documented.

RESULTS: Radiofrequency ablation and mucosal plication procedure on average resulted in short operation time (9 vs. 32 minutes, p < 0.05), shorter hospitalization (16 vs. 42 hours, p < 0.05) significantly less postoperative pain, fewer cumulative requests for analgesia by the patients (21 vs. 54 tablets, p < 0.05), earlier return to work (7 vs. 18 days, p < 0.05) and faster wound healing (14 vs. 35 days, p < 0.05) The complication rate was 9% with RAMP group and 29% with LEP group.

CONCLUSION: The procedure of radiofrequency ablation and plication of mucosa shows promising results in patients with rectal mucosal prolapse. Being safe, effective, and a swift technique, it can be proposed as an improved alternative to conventional surgical procedure.