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Shrestha P, Karmacharya RM, Dhakal P, Bade S, Dahal S, Bhandari N, Bade S. Predicting factors of patient satisfaction after varicose vein surgery at a university hospital in Nepal. JOURNAL OF VASCULAR NURSING 2023; 41:180-185. [PMID: 38072570 DOI: 10.1016/j.jvn.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Varicose veins are a common vascular problem with a high prevalence, yet they are often neglected. The main objective of this study was to explore the patient satisfaction after varicose vein surgery, along with its predicting factors. To our knowledge, no similar study has been conducted in Nepal to date. METHODOLOGY This retrospective cross-sectional study included patients who underwent varicose vein surgery at Dhulikhel Hospital from September 2019 to February 2020. The satisfaction level after the surgery was assessed using a 10-point Likert scale questionnaire during a telephone interview with their verbal consent. Descriptive statistics and linear regression were performed to identify the predicting factors of patient satisfaction. RESULTS Among a total of 84 patients interviewed, 53.6% were male. The mean age of the participants was 43.13 ± 13.62 years. The mean patient satisfaction score was 42 ± 5.5, with nursing service, discharge teaching and hospital service being the highest scoring items in terms of patient satisfaction. Linear regression revealed age ≤40 years as a predictor of higher patient satisfaction (β=0.258, p=0.015) while early stage of varicose veins (β=-0.233, p=0.026) and duration of post-operative follow-up (β=-0.25, p=0.021) were negative predictors of patient satisfaction. This means that patients with C2-C3 venous disease and longer duration of postoperative follow-up tended to have lower satisfaction scores. CONCLUSION The overall patient satisfaction following varicose vein surgery was very good, and the major predictors of better satisfaction were age ≤40 years, C4-C6 clinical classification of venous disease and the shorter duration of follow-up after surgery.
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Affiliation(s)
- P Shrestha
- Department of Nursing and Midwifery, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Nepal.
| | - R M Karmacharya
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal.
| | - P Dhakal
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - S Bade
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - S Dahal
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - N Bhandari
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - S Bade
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
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Chernookov AI, Kuznetsov MR, Kandyba SI, Dolgov SI, Atayan AA, Ramazanov АA. Prevention of relapses of varicose veins in patients with true doubling of the great saphenous vein. AMBULATORNAYA KHIRURGIYA = AMBULATORY SURGERY (RUSSIA) 2022. [DOI: 10.21518/1995-1477-2022-19-2-30-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction. True doubling of great saphenous vein is observed in 1.6–2.1% of patients with varicose veins and may be one of the reasons for the development of postoperative relapse of the disease. Performing endovasal laser coagulation (EVLC) of both great saphenous vein trunks makes it possible to increase the radicality of the intervention and reduce the likelihood of a recurrence of varicose veins.Aim. Based on the study of immediate and long-term results, to substantiate the expediency of using EVLC of the main and true additional stem of great saphenous vein in patients with varicose veins.Materials and methods. From 2014 to 2020, 24 patients with a true doubling of great saphenous vein were treated. Among the applicants there were 12 women and 12 men aged 23 to 62 years with clinical class C2–C4 according to the CEAP (Clinical, Etiologic, Anatomic, Pathophysiologic) classification. All patients under tumescent anesthesia underwent simultaneous EVLC of the main and accessory trunk of the BPV, followed by miniflebectomy or sclerobliteration of varicose tributaries.Results and discussion. The use of simultaneous coagulation of both trunks was performed by all patients, thus the technical success of the operation was observed in 100% of cases. There were no intraoperative complications. The use of such a volume of intervention is accompanied by an increase in the duration of the operation by 29.3%. Hyperpigmentation in the projection of the coagulated trunk was observed in 2 (8.3%) patients, neurological disorders – in 1 (4.2%) patient. During the examination of patients 1–2 years after the operation, no relapses of the disease were detected, and the cosmetic result of the intervention on a ten-point scale, patients on average estimated at 7.6 points.Conclusions. True doubling of the great saphenous vein is rare and may increase the likelihood of relapses of the disease. EVLC of the main and additional BPV trunks is accompanied by an increase in the duration of surgery by an average of 29.3%, and the number of patients with hyperpigmentation by 1.5 times. Simultaneous EVLC of both tables with true duplication of BPV makes it possible to reliably block a potential source of varicose disease recurrence and reduce the likelihood of recurrent veins.
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Affiliation(s)
| | - M. R. Kuznetsov
- Main Clinical Hospital named after Academician N.N. Burdenko
| | - S. I. Kandyba
- Main Clinical Hospital named after Academician N.N. Burdenko
| | | | - A. A. Atayan
- Sechenov First Moscow State Medical University (Sechenov University)
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Hummel T, Aryafar A, Mayböck N, Mumme A, Stücker M, Mühlberger D. "Quality of Life after Varicose Vein Surgery in Patients with High-ligation and Stripping, External Valvuloplasty and Sapheno-femoral Redo Surgery". Ann Vasc Surg 2021; 74:331-338. [PMID: 33548404 DOI: 10.1016/j.avsg.2020.12.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/17/2020] [Accepted: 12/26/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND High-ligation and stripping (HL/S) and external valvuloplasty (eVP) with the implantation of an external device to restore the valve's function, are surgical methods to eliminate reflux at the saphenofemoral junction. Furthermore, redo-surgery (RedoS) can be performed in terms of same side groin recurrences. It is unclear, if there is a difference in quality of life (QoL) between these 3 surgical treatment options. Therefore, it was the aim of our study to elucidate QoL in patients before and after surgical treatment at the saphenofemoral junction by comparing HL/S, eVP, and RedoS. METHODS A total of 303 participants (156 HL/S, 81eVP, 64 RedoS) were recruited during the daily clinical routine. QoL was measured at admission and 6 weeks after the surgical procedure by means of SF-12 (12 item short form health survey) and Aberdeen Varicose Vein Questionnaire. RESULTS The mean value of Aberdeen Varicose Vein Questionnaire was 14.5 (SD 2.1) preoperatively and 4.9 (SD 3.3) postoperatively in the HL/S group, 16.4 (SD 1.4) preoperatively and 6.8 (SD 2.5) postoperatively in the eVP group and 15.5 (2.2) preoperatively and 5.8 (SD 4.2) postoperatively in the RedoS group, which was statistically significant (P< 0.05) in all groups. Postoperatively, the mean values were statistically significant within the groups. Concerning physical aspects of the SF-12 we found a significant improvement in the RedoS group, while mental aspects were significantly better in the HL/S and eVP group postoperatively. Nevertheless, the clinical relevance of these SF-12 differences is questionable under consideration of the minimal important difference. CONCLUSIONS Varicose vein surgery leads to a significant improvement of QoL in all groups. The implantation of an external patch could have a negative influence in QoL.
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Affiliation(s)
- Thomas Hummel
- Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany; Vein Center of the Departments of Dermatology and Vascular Surgery, Katholisches Klinikum Bochum, Germany
| | - Annahita Aryafar
- Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany
| | - Nora Mayböck
- Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany; Vein Center of the Departments of Dermatology and Vascular Surgery, Katholisches Klinikum Bochum, Germany
| | - Achim Mumme
- Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany; Vein Center of the Departments of Dermatology and Vascular Surgery, Katholisches Klinikum Bochum, Germany
| | - Markus Stücker
- Vein Center of the Departments of Dermatology and Vascular Surgery, Katholisches Klinikum Bochum, Germany; Department of Dermatology, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany
| | - Dominic Mühlberger
- Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany; Vein Center of the Departments of Dermatology and Vascular Surgery, Katholisches Klinikum Bochum, Germany.
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Park I, Kim JY, Lee H, Park G, Park J, Hwang H, Yun S, Ohe H, Hong KP, Park JK, Jang JH, Yun SS. Draft Revision of Clinical Practice Guidelines for Varicose Veins -Treatment-. Phlebology 2020. [DOI: 10.37923/phle.2020.18.2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Jang Yong Kim
- Division of Vascular and Transplant Surgery, Department of Surgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
| | - Hogyun Lee
- Division of Vascular and Transplant Surgery, Department of Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Geunmyeong Park
- Division of Vascular and Transplant Surgery, Department of Surgery, Inha University Hospital, Inchon, Korea
| | - Junho Park
- Happy Varicose Vein Clinic, Seoul, Korea
| | - Hongpil Hwang
- Division of Vascular and Transplant Surgery, Department of Surgery, Jeonbuk National University Hospital, Jeonju, Korea
| | - Sangchul Yun
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Haengjin Ohe
- Division of Vascular and Transplant, Department of Surgery, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Ki-Pyo Hong
- Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jong Kwon Park
- Division of Vascular and Transplant, Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | | | - Sang Seob Yun
- Division of Vascular and Transplant Surgery, Department of Surgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
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Sevil F, Colak A, Ceviz M, Kaya U, Becit N. The Effectiveness of Endovenous Radiofrequency Ablation Application in Varicose Vein Diseases of the Lower Extremity. Cureus 2020; 12:e7640. [PMID: 32399372 PMCID: PMC7216314 DOI: 10.7759/cureus.7640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We aimed to determine the outcome, complications, and quality of life effects of radiofrequency ablation (RFA) in the treatment of superficial venous insufficiency. A total of 134 extremities from 100 patients were evaluated in this retrospective study performed at the Cardiovascular Surgery Department of Atatürk University Faculty of Medicine. Treatment success was determined by occlusion. The clinical, etiologic, anatomic, and pathophysiologic (CEAP) and venous clinical severity score (VCSS) scores of patients were assessed pre- and postoperatively to evaluate clinical outcome and quality of life. The pain was assessed with the Wong-Baker score. Complications and their frequency were assessed and recorded. Treatment success, as measured by occlusion rate, was 99% percent. Prior to treatment, the CEAP clinical score was C2 (81.0%), while after treatment, it was C0 (54.0%) (p<0.001). The pretreatment median VCSS score was 5 (min-max: 1-9) while the post-treatment median was 1 (min-max: 1-3) (p<0.001). The mean pain score was 1.34; only one patient reported a score of 6 while the minimum score was 1. A total of 15 complications occurred; only one was a major complication (deep vein thrombosis or DVT) while the remaining 14 were minor complications. While longstanding surgical treatments still provide significant success, the RFA technique not only surpasses them in success rate but also in terms of pain, complications, and better patient satisfaction. The results of our study indicate that RFA is an effective and safe option for the treatment of superficial venous insufficiency.
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Affiliation(s)
- Fehimcan Sevil
- Cardiovascular Surgery, Afyon Health Sciences University, Afyon, TUR
| | - Abdurrahim Colak
- Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR
| | - Münacettin Ceviz
- Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR
| | - Uğur Kaya
- Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR
| | - Necip Becit
- Cardiovascular Surgery, Afyon Medical Sciences University, Afyon, TUR
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Ahmed M, Lutze S, Tembulatow M, Daeschlein G, Jünger M, Arnold A. Long-term outcome of open surgery in CVI patients concerning postoperative complications, perioperative hemodynamics and clinical efficacy, Part II1. Clin Hemorheol Microcirc 2018; 71:117-127. [PMID: 30584123 DOI: 10.3233/ch-189401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic venous disease (CVD) is extremely common worldwide with prevalence increasing with age. It is associated with a reduced quality of life, particularly in relation to pain, physical function and mobility. Symptomatic chronic venous insufficiency (CVI) with venous ulcer at its' endpoint, indicates interventional surgery to cure venous reflux therewith promoting wound healing and preventing recurrence. In this retrospective, single-centre, consecutive case-control study in a single patient population of a university clinic in northern Germany a holistic evaluation of varicose vein surgeries has been undertaken. Part I covered postoperative complications in relation to co-morbidities, co-medication and clinical presentation. Part II of this article presents now the hemodynamic results in relation to the perioperative evolution of CVI specific symptoms. METHODS Records of n = 429 (467 extremities) patients from 2009-2013 treated with open surgery were analysed with regards to perioperative hemodynamics. Evolution of CVI symptomology was accessed postoperatively with the help of a questionnaire and patient records in the case of complication development. Venous hemodynamics was analysed in the whole patient population and with regards to complication subgroups: no events (NE), neglectable adverse events (NAE) and non-neglectable adverse events (NNAE). RESULTS Postoperatively, patients' CVI-symptoms like pain (p < 0.001), swelling (p < 0.001) and itching (p = 0.003) significantly improved. The venous refill time and venous pump capacity improved significantly after open vein surgery (p < 0.05). Regardless of the development of postoperative complications there was a significant improvement of venous function at 6 weeks- and one-year postoperative in follow-up (p < 0.05). Symptom regression was strongly correlated with hemodynamic improvement. CONCLUSION A significant improvement of patients' symptoms was achieved by means of open-surgery, regardless of postoperative complication development. This was in accordance with the improvement of venous hemodynamics. A strong correlation between symptom regression and improvement in venous hemodynamics could be proven.
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Affiliation(s)
- M Ahmed
- Dermatological Clinic of the University of Greifswald, Germany
| | - S Lutze
- Dermatological Clinic of the University of Greifswald, Germany
| | - M Tembulatow
- Dermatological Clinic of the University of Greifswald, Germany
| | - G Daeschlein
- Dermatological Clinic of the University of Greifswald, Germany
| | - M Jünger
- Dermatological Clinic of the University of Greifswald, Germany
| | - A Arnold
- Dermatological Clinic of the University of Greifswald, Germany
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Poder TG, Fisette JF, Bédard SK, Despatis MA. Is radiofrequency ablation of varicose veins a valuable option? A systematic review of the literature with a cost analysis. Can J Surg 2018; 61:128-138. [PMID: 29582749 PMCID: PMC5866149 DOI: 10.1503/cjs.010114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Since the 1990s, new techniques for the treatment of varicose veins have emerged, including radiofrequency ablation (RFA) and laser treatment. We performed a study to compare the safety, efficacy and outcomes of RFA compared to those of open surgery and laser ablation for the treatment of varicose veins. We also carried out a cost analysis of RFA compared to open surgery to assess whether RFA could help free up operating room time by being performed in an outpatient context. METHODS We conducted a systematic literature review (publication date May 2010-September 2013 for articles in English, January 1991-September 2013 for those in French). We used several checklists to measure the quality of the studies. We also collected data on costing. RESULTS The literature search identified 924 publications, of which 38 were retained for analysis: 15 literature reviews, 1 good-practice guideline and 22 new primary studies. The overall level of evidence was low to moderate owing to the limited sample sizes, lack of information on patient characteristics and lack of standardization of the outcome measures. However, the results obtained are consistent from study to study. In the short and medium term, RFA is considered as effective as open surgery or laser treatment (moderate level of evidence) and presents fewer major and minor complications than open surgery (low level of evidence). Radiofrequency ablation can be performed on an outpatient basis. We calculated that RFA would be about $110-$220 more expensive per patient than open surgery. CONCLUSION Radiofrequency ablation is a valuable alternative to open surgery and would free up operating room time in a context of low accessibility.
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Affiliation(s)
- Thomas G Poder
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
| | - Jean-François Fisette
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
| | - Suzanne K Bédard
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
| | - Marc-Antoine Despatis
- From the Unité d'évaluation des technologies et des modes d'intervention en santé (UETMIS) and the Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Poder); the Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que. (Fisette); CRCHUS, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Bédard); and the Vascular Surgery Unit, CIUSSS de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Que. (Despatis)
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Kim KY, Kim JW. Early experience of transilluminated cryosurgery for varicose vein with saphenofemoral reflux: review of 84 patients (131 limbs). Ann Surg Treat Res 2017; 93:98-102. [PMID: 28835886 PMCID: PMC5566753 DOI: 10.4174/astr.2017.93.2.98] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/23/2017] [Accepted: 03/04/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Varicose veins with great saphenous vein (GSV) insufficiency is prevalent. Among various surgical treatments for varicose veins, cryosurgery of GSV is an alternative minimally invasive technique that could leave fewer scars and replace conventional stripping with ambulatory phlebectomy. This study sought to assess outcomes including efficacy and safety of cryosurgery for varicose veins. METHODS One hundred thirty-one limbs in 84 patients (37 male, 47 female; mean age, 53.3 years) with varicose veins were treated with cryosurgery over a 2-year period. The patients were followed for postoperative complication with surveillance of recurrence. The analyzed variables included age, sex, symptom, operative time (from skin incision to the application of elastic bandages on the legs for compression purposes), and postoperative complications including bruising, hematoma, superficial thrombophlebitis, cellulitis, seroma, cutaneous nerve damage, and wound complication. RESULTS The mean operative time was 64.7 minutes for both limbs and 44 minutes for single limbs. The median number of incisions was 2. For stripping of GSV, one incision at the groin was necessary. Postoperative complications included an episode of hematoma in 3 limbs (2.3%), cutaneous nerve damage in 3 limbs (2.3%), cellulitis in 2 patients (1.5%), and seroma in 1 limb (0.8%). No wound infection, thrombophlebitis or deep venous thrombosis was observed. During follow-up (mean follow-up period, 13.5 months; range, 3-28 months), there was no recurrence. CONCLUSION Cryosurgery to treat varicose veins is an effective and safe treatment modality in terms of postoperative complication, cosmetic result, and recurrence.
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Affiliation(s)
- Kwang Yong Kim
- Department of Surgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Surgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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Jin HY, Ohe HJ, Hwang JK, Kim SD, Kim JY, Park SC, Kim JI, Won YS, Yun SS, Moon IS. Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year. Asian J Surg 2016; 40:48-54. [PMID: 27378121 DOI: 10.1016/j.asjsur.2016.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/28/2016] [Accepted: 03/29/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Endovenous treatment is increasingly supplanting open surgery for the treatment of varicose veins. Among emerging endovenous techniques, radiofrequency ablation (RFA) with a ClosureFast catheter is popular in Korea. The objective of this study was to evaluate and compare the efficacy and patient-reported outcomes of RFA of varicose veins. METHODS This is a retrospective study of a prospectively registered database of patients who underwent RFA for varicose veins from 2012 to 2013 in St. Mary's Hospital in Seoul. Korea. Efficient ClosureFast RFA catheters (Medtronic, San Jose, CA, USA) were used. The techniques used for RFA of varicose veins were performed according to the manufacturer's recommendations. Duplex scans and venous clinical severity scores (VCSSs) were used to document treatment outcome and patient symptoms before and after the procedures. Treatment outcomes were estimated before the procedure and 3 months, 6 months, and 12 months after the procedure. Outcomes were analyzed by paired t test, chi-square test, or Fisher's exact test as well as by logistical regression. RESULTS A total of 117 patients were evaluated for 183 consecutive RFA procedures (183 limbs). The initial technical success was 97.3% (178/183). The estimated mean VCSS changed over time from 4.0 ± 1.67 at preprocedure to 0.6 ± 1.05, 0.5 ± 1.02, and 0.6 ± 1.14 at 3 months, 6 months, and 12 months after the procedure, respectively. The improved VCSS was maintained 1 year after the procedure (p < 0.001). Recanalization of the saphenous vein was detected in 20 limbs at the 1-year follow up. The treatment failure group also exhibited a significant decline in the VCSS between preprocedure and 12 months (4.8 ± 1.76 vs. 1.8 ± 2.04, p < 0.001). Specifically, in the treatment failure group, 65% of limbs with episodic recanalization (13/20) were reoccluded or recanalized without venous reflux at the 1-year follow up. CONCLUSION In this study, RFA of varicose veins had an initial success rate of 97.7% and a significantly improved patient VCSS at 1 year. Patients with episodic recanalization of the saphenous vein also exhibited an improved VCSS with favorable duplex findings at 1 year.
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Affiliation(s)
- Hyeong Yong Jin
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Haeng Jin Ohe
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Jeong Kye Hwang
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Sang Dong Kim
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Jang Yong Kim
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Sun Cheol Park
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Ji Il Kim
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - Yong Sung Won
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
| | - Sang Seob Yun
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
| | - In Sung Moon
- Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea
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van Eekeren RR, Boersma D, de Vries JPP, Zeebregts CJ, Reijnen MM. Update of endovenous treatment modalities for insufficient saphenous veins—A review of literature. Semin Vasc Surg 2014; 27:118-36. [DOI: 10.1053/j.semvascsurg.2015.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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