[Comparison of variceal surgery methods].
Combined ablation of great saphenous vein (GSV) remains the most common way of lower limb variceal management. In recent years different surgical methods were proposed for the treatment of varices. Nevertheless, their invasiveness, poor esthetic outcome, prolonged postoperative rehabilitation and recurrences cail for the development of new minimally invasive and highly effective methods. In the last 5 years a new procedure of intraoperative trunk catheter scieroobliteration of GSV and its tributaries was introduced. From 1997 to 2002 total 493 surgical corrections of lower limb varices were fulfilled, among them 374 patients were operated for primary variceal vein dilatations including 188 standard combined venectomies (1st group) and 186 trunk obliterations (2nd group). Groups were similar in age, sex and lesion extension. Outcomes were followed up to 4 weeks - 5 years. Outcomes comparison between groups has demonstrated significantly lower incidence of postoperative subcutaneous hematomas in the 2nd group, absence of saphenous nerve injuries, better esthetics in the absence of additional incisions (remaining variceal tributaries were sclerosed postoperatively by puncture scieroobliteration). Besides postoperative rehabilitation period was double shorter in ihe 2nd group then in the 1st one. Recurrence rate in long-term period was similar in both groups. Thus intraoperative trunk scieroobliteration of GSV can be a valuable alternative for standard combined venectomy.
Gavrilenko
A V
AV
Department of Vascular Surgery, Russian Research Center of Surgery, Russian Academy of Medical Science, Moscow, Russia.
Vakhrat'ian
P E
PE
Shkatov
V A
VA
Gorina
S M
SM
Fateeva
I E
IE
Dutikova
E F
EF
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D035002:Lower Extremity / Q000098:blood supply / Q000601:surgery*; D008297:Male; D012501:Saphenous Vein / Q000503:physiopathology / Q000601:surgery*; D015911:Sclerotherapy / Q000379:methods; D012720:Severity of Illness Index; D014648:Varicose Veins / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D014656:Vascular Surgical Procedures / Q000379:methods*