Radiofrequency coagulation with Thiersch's operation--a better palliative treatment in prolapse rectum.

Current surgery · 2002 · Unclear · Very low evidence

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UnclearVery low evidencePaper 3797

In 8 patients treated with circumferential subanodermal coagulation using a radiofrequency device followed by Thiersch operation, follow-up of 15–18 months was reported as satisfactory. The authors report no prolapse/related sequelae and no cases of sinus or …

Study snapshot

PublicationCurrent surgery · 2002

Study typeother

Reported directionUnclear

Evidence ratingVery low

Abstract

PURPOSE: Thiersch operation is an age-old popular option for treatment of complete rectal prolapse (proctodentia) in elderly patients. This procedure is simple, easy to perform, and with very rare postoperative complications of any severe nature. This is especially suitable for those patients who are unfit for extensive abdominal surgical procedures in practice today. This procedure does help in mechanically supporting and containing the prolapse. Although the procedure is not curative, the confining of the prolapse in the anal canal does ensure a relief from symptoms generated by the prolapse. Nevertheless, withdrawal of the occlusive material used is inevitably followed by recurrence of the prolapse, making the procedure a failure in achieving a prolonged relief. METHODS: Looking at this drawback, we have made an addition to this conventional procedure by introducing circumferential coagulation of the subanodermal region through a radio frequency device. This results in inducing fibrosis and forming a zone of band. The added maneuver constricts the anal opening permanently and thus aids in reinforcement of the atonic sphincter. The study was carried out in 8 patients. Their average age was 57 years. All of them had complete prolapse of the rectum with associated features. Two of them were in early fifties, but they refused to undergo extensive procedures and opted for this method considered cheaper and quicker. RESULTS: A follow-up for a period ranging from 15 to 18 months was found satisfactory. None of the patients had any prolapse or its sequel. Not a single case was reported for any sinus or discharge from the site of incision. The incision site was well consolidated, and the knot or the thread could not be felt when seen after 12 months. CONCLUSIONS: The study shows that radio frequency coagulation followed by Theirsch operation for complete rectal prolapse in the elderly has been found to be relatively easy to perform. Except for the radio surgical unit, no special instrumentation is needed. The results of this procedure have been found to be gratifying in all the patients. It is felt that on appropriate selection of the patients and employing this new technique of operation would prove a boon in treatment of this problem. A further work in this direction and longer follow-up of the treated patients are bound to bring about exciting new dimensions in the field.

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typeother

Effect directionunclear

PopulationPatients with complete rectal prolapse (elderly/unfit for extensive abdominal surgery; mean age 57 years)

Sample size8

ExposureNot supplied

Evidence strengthVery lowConfidence: 74% · Peer reviewed: yes

Main findings

Outcomes measured

Recurrence of rectal prolapse
Postoperative complications (sinus/discharge)
Incision site healing/consolidation
Palpability of knot/thread

Limitations

Very small sample size (n=8)
No comparator/control group described
Follow-up limited to 15–18 months
Patient selection details limited; includes some non-elderly patients who refused extensive procedures
Radiofrequency exposure parameters (frequency, power, dose) not reported

View raw extracted JSON

{
  "study_type": "other",
  "exposure": {
    "band": null,
    "source": "radiofrequency surgical device (radiofrequency coagulation)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "Patients with complete rectal prolapse (elderly/unfit for extensive abdominal surgery; mean age 57 years)",
  "sample_size": 8,
  "outcomes": [
    "Recurrence of rectal prolapse",
    "Postoperative complications (sinus/discharge)",
    "Incision site healing/consolidation",
    "Palpability of knot/thread"
  ],
  "main_findings": "In 8 patients treated with circumferential subanodermal coagulation using a radiofrequency device followed by Thiersch operation, follow-up of 15–18 months was reported as satisfactory. The authors report no prolapse/related sequelae and no cases of sinus or discharge; the incision site was well consolidated and the knot/thread was not felt after 12 months.",
  "effect_direction": "unclear",
  "limitations": [
    "Very small sample size (n=8)",
    "No comparator/control group described",
    "Follow-up limited to 15–18 months",
    "Patient selection details limited; includes some non-elderly patients who refused extensive procedures",
    "Radiofrequency exposure parameters (frequency, power, dose) not reported"
  ],
  "evidence_strength": "very_low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "radiofrequency coagulation",
    "Thiersch operation",
    "rectal prolapse",
    "proctodentia",
    "palliative treatment",
    "fibrosis",
    "surgery"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1016/s0149-7944(02)00634-7
PubMed: 16093194

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