[Transillumination-assisted phlebectomy with the help of the TriVex system in comprehensive management of varicose disease of lower-limb veins].
The present work was undertaken to evaluate a new minimally invasive method of surgical management of varicose disease by means of the TriVex unit. The method is based on transillumination of saphenous veins in an aqueous medium, which makes it possible to perform radical removal thereof form separate punctures under visual control with the help of a specially designed vein stripper. Transillumination-assisted phlebectomy (TIP) was compared with microphlebectomy (MPE) according to the Varady's technique. We operated on a total of one hundred and eight patients suffering from varicose disease of the lower extremities. All of them underwent duplex scanning of the veins. Group One (study group) was composed of fifty-six patients subjected to TIP within the scope of a comprehensive treatment for varicose disease. Group Two consisted of fifty-two patients who were subjected to removal of varicosely altered affluents on the crus by means of microphlebectomy. The results of surgical management for varicose disease were analysed according to the following parameters, the duration of a surgical intervention, intensity of the pain syndrome in the postoperative extremity, a cosmetic outcome by visual analogue scales, and the incidence rate of complications. The obtained findings demonstratively showed that the duration of the operation in the study group was substantially shorter, averagely amounting to 35.5+/-6.2 minutes, as compared with as long as 65.0+/-6.2 minutes (P<0.0001) in the control group. The number of incisions in the study group turned out to be also significantly less than that in the control group, amounting to 4.0+/-1.3 vs. 12.0+/-2.5 (p<0.0001), which largely contributed to both a decrease in the level of the pain syndrome and obtaining aesthetically pleasing cosmetic outcomes. Hence, TIP being a minimally invasive procedure in surgical management of varicose disease, by its clinical efficiency appeared to be not inferior and at least equivalent to microphlebectomy, displaying at the same time certain advantages over the latter, consisting in the very positive cosmetic outcome obtained, a lesser operative injury inflicted, and shorter terms of rehabilitation of the patients involved.
Nazarenko
G I
GI
Kungurtsev
V V
VV
Sidorenko
V I
VI
Egorov
V V
VV
Makarov
V P
VP
Zvereva
L S
LS
Kungurtsev
E V
EV
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014172:Transillumination / Q000295:instrumentation*; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000295:instrumentation*