Annals of Coloproctology

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Original Article

Anorectal benign disease

Propensity score–matched comparative study of radiofrequency ablation (with the Rafaelo device) versus hemorrhoidectomy for the treatment of grades II–III internal hemorrhoids: Thanat Tantinam, Pawit Sutharat, Suwan Sanmee, Ekkarin Supatrakul, Kullawat Bhatanaprabhabhan, Boonchai Ngamsirimas, Nataphon Santrakul, Rangsima Thiengthiantham, Punnawat Chandrachamnong; Ann Coloproctol. 2025;41(5):409-416. Published online September 30, 2025; DOI: https://doi.org/10.3393/ac.2025.00458.0065

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Abstract PDF: Purpose
Hemorrhoidal disease impacts quality of life, with hemorrhoidectomy being the standard treatment for grades II–III hemorrhoids. Radiofrequency ablation (RFA) using the Rafaelo technique offers a less invasive alternative; however, comparative data remain limited. This study evaluated short-term outcomes following RFA versus conventional hemorrhoidectomy.
Methods
A single-center retrospective cohort study was conducted at a medical university hospital in Thailand, involving patients who underwent either RFA or hemorrhoidectomy between January 2023 and September 2024. Propensity score matching was utilized to minimize selection bias. Primary outcomes were postoperative pain and opioid consumption.
Results
After propensity score matching, 102 patients were analyzed (51 patients in each group). Baseline characteristics were well-balanced between the 2 groups. The RFA group had higher pain scores at 8 hours postoperatively (1 vs. 0, P=0.002) but lower scores at 20 hours (0 vs. 1, P<0.001). Opioid consumption was significantly lower in the RFA group (9.8% vs. 31.4%, P=0.007), with a reduced morphine-equivalent dose (0.7 mg vs. 3.5 mg, P=0.003). Additionally, the RFA group had a shorter operative time (20 minutes vs. 30 minutes, P<0.001) and less intraoperative blood loss (0 mL vs. 5 mL, P<0.001). Hospital stays and complication rates were comparable between groups.
Conclusion
RFA resulted in improved postoperative pain control, reduced opioid use, shorter operative duration, and decreased blood loss compared to hemorrhoidectomy, with similar hospital stay durations and complication rates.

Review Article

Others

Unraveling the enigma of sclerosing encapsulating peritonitis: a comprehensive review: Witcha Vipudhamorn, Tawan Juthasilaparut, Pawit Sutharat, Suwan Sanmee, Ekkarin Supatrakul, Sayanan Chowsilpa, Kraipop Wongwaiyut, Rujee Rattanasathien; Ann Coloproctol. 2025;41(3):175-189. Published online June 18, 2025; DOI: https://doi.org/10.3393/ac.2024.00486.0069

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Abstract PDF: Sclerosing encapsulating peritonitis (SEP) is a rare but serious condition characterized by the progressive formation of a dense fibrous sheath encasing the small bowel within the peritoneal cavity. This review provides a comprehensive overview of the current understanding of SEP, focusing on its etiology, clinical presentation, diagnostic modalities, and management strategies. SEP can be classified into primary and secondary forms, each with distinct etiologies and treatment approaches. Primary SEP typically presents with acute or subacute bowel obstruction symptoms, necessitating surgical intervention to excise the fibrous sheath and relieve the obstruction. Secondary SEP often occurs in patients undergoing peritoneal dialysis, with cessation of dialysis being a key component of management. Medical treatments, including corticosteroids, immunosuppressive agents, and nutritional support, may complement surgical intervention, particularly in cases of secondary SEP. Advanced imaging techniques and personalized medicine approaches show promise in improving diagnostic accuracy and tailoring treatment strategies to individual patients. Future research directions include investigating targeted pharmacological therapies, exploring minimally invasive surgical techniques, and conducting long-term follow-up studies to evaluate treatment efficacy and disease recurrence. Multidisciplinary care teams play a crucial role in the comprehensive management of SEP, emphasizing collaboration among various specialties to optimize patient outcomes.

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