LAUSR

Haemorrhoidal disease (HD) is a common perianal condition. There is still limited data on the role of minimally invasive surgery for HD. The aim of our study was to report the outcome of radiofrequency ablation of haemorrhoids under local anaesthetic (RAFAELO) at our institution. 23 patients who had a day-case RAFAELO procedure under local anaesthesia without sedation by a single surgeon from March to October 2022 were retrospectively reviewed. We analysed patients’ demographics, haemorrhoid severity score (HSS), the health's condition scale in EQ-5D-5L questionnaire, and recurrence rate. The mean age of patients was 50 years (SD 14). 65% were male whereas 35% were female. Majority of haemorrhoids (48%) were Grade 3A. Most of the cases had previous procedures such as rubber band ligation (57%) and hemorrhoidal dearterialization (9%). Only 34% had no prior hemorrhoidal surgery. The mean HSS score significantly improved from 13.2 (SD 4.9) to 4 (SD 2.2) with p < 0.001 postoperatively. The health's condition scale became significantly lower from 64 (SD 23.6) to 23.9 (SD 14.6) with p < 0.001. The median length of follow up was 2 months (range 1-5 months). There was no acute postprocedural complication but there was a recurrence rate of 13% requiring further procedures. This study supports previous findings that RAFAELO is a safe and effective procedure for HD. It also highlights that it can be performed in the out-patient setting safely. However, further studies with larger samples, longer follow-up and comparison with other procedures are suggested.