Abstract
The purpose of this study was to compare outcomes (within six months) after short stripping (SS) and endovenous laser obliteration (EVLO) in patients with varicose veins when analyzing ultrasound findings, postoperative complications, level of postoperative pain, clinical manifestations, and duration of rehabilitation after the intervention. Patients with varicose veins of lower extremities and insufficiency of large saphenous vein valves had either EVLO or SS with miniflebectomy. All patients were examined before surgery and then in 5 days, 10 days and in 1, 3 and 6 months after it. The patients also had clinical examination, ultrasound duplex scanning of their lower extremity veins; Venous Clinical Severity Score (VCSS) was also used for the trial. Pain was assessed during the first 10 days after the surgery using a 10-point pain assessment scale. 156 patients (177 lower extremities) were followed-up for 6 months. As the results of our study showed, endovenous laser obliteration and short stripping were equally effective in eliminating the reflux of the great saphenous vein (GSV). After 6 months of follow-up, the reflux along the medial inflow was noted in one case in SS group; partial GSV recanalization was noted in one case in EVLO group in 3 months, in 3 cases – in 6 months. Besides, despite LMH preventive doses one patient from EVLO group had EHIT II deep vein thrombosis. The obtained outcomes have demonstrated that EVLO and SS have similar effectiveness and safety. No difference has been found between these two types of treatment, except more pronounced postoperative pain and bruising in SS group. Performed care was equally safe and effective in eliminating GSV reflux, in relieving symptoms and eliminating varicose veins as well as in improving the quality of life. Long-term outcomes, especially the rate of relapses depending on the type of intervention, are to be investigated in future trials.
Highlights
В сравнительное проспективное исследование включили 156 пациентов (177 нижних конечностей) с варикозной болезнью, которым провели комбинированную флебэктомию или эндовенозную лазерную облитерацию на нижних конечностях в бассейне большой подкожной вены (БПВ) в 2020 г. в отделении сосудистой хирургии Российского научного центра хирургии им. акад
Отсутствие рефлюкса на бедре по данным УЗИ, n No reflux at the hip according to US examination, n
В послеоперационном периоде наблюдение (до 6 месяцев) за схожими группами больных с варикозной болезнью нижних конечностей, которым выполнена ликвидация патологического рефлюкса по большой подкожной вены (БПВ) на бедре с применением двух вариантов воздействия (короткий стриппинг и эндовенозной лазерной облитерации (ЭВЛО)), не показало клинических приоритетов той или иной методики
Summary
В сравнительное проспективное исследование включили 156 пациентов (177 нижних конечностей) с варикозной болезнью, которым провели комбинированную флебэктомию или эндовенозную лазерную облитерацию на нижних конечностях в бассейне большой подкожной вены (БПВ) в 2020 г. в отделении сосудистой хирургии Российского научного центра хирургии им. акад. По результатам множества исследований по сравнению эффективности, частоты осложнений и качества жизни пациентов нет достоверной разницы между методами термической термооблитерации ствола большой подкожной вены: эндовенозной лазерной облитерации (ЭВЛО) и радиочастотной облитерации (РЧО) [3, 4].
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