Endovenous Laser Therapy Combined with Planing Aspiration Operation for Great Saphenous Varicose (Experiences of 48 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LILe , LIHong-tao , CAOTing-bao , ZHUWan-kun , HANXiao-peng ,  LIUHong-bin

Department of General Surgery, Lanzhou General Hospital of Lanzhou Military Region, Lanzhou 730050, Gansu Province, China;

Corresponding?author：

LIUHong-bin, Email: liuhongbin999@163.com

Keywords：

Endovenous laser closure; Planing aspiration; Varicosis; Minimal invasive; High ligation of great saphenous vein; Phlebothrombosis

DOI：

10.7507/1007-9424.20160317

Video：

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Objective To observe the efficiency of endovenous laser therapy combined with planning sucking operation in the treatment of great saphenous varicose veins. Methods Totally 48 patients (60 limbs) were treated from May 2011 to May 2014 in general surgery department of our hospital. The main trunk of great saphenous vein was ablated by endovenous laser treatment; and the varicose veins in calf were resected by planning sucking operation. Results All 48 patients (60 limbs) were cured without recurrent during 6-36 months followed-up. The operative time of each side was 18-43 min, the average operative time was 22.6 min; with 1-3 skin incisions. Hospital stay was 5-8 d, the average hospitalization time was 6.7 d. After operation, the varicose veins and the felling of swelling were disappeared, the pigmentation was reduced or disappeared. Local skin numbness showed in 6 cases and recovered in 3-7 months after operation. Felling of burns appeared in 2 cases, and was healed after treatment. Ankle swelling presented in 5 cases, and released in 6-13 d with related treatment. Different degree of subcutaneous bruising appeared without any hematoma, and recovered in 2-4 weeks. Two cases were lost during the followed-up. Conclusions Endovenous laser therapy combined with planning sucking operation is safe and effective in the treatment of great saphenous varicose. It is worthy of promotion with minimum damage, less pain, fast recovery, no scars, shorter operative time, and shorter hospital stay.

Citation： LI Le, LI Hong-tao, CAO Ting-bao, ZHU Wan-kun, HAN Xiao-peng, LIU Hong-bin. Endovenous Laser Therapy Combined with Planing Aspiration Operation for Great Saphenous Varicose (Experiences of 48 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(10): 1236-1238. doi: 10.7507/1007-9424.20160317 Copy

1.	Lin JC, Nerenz DR, Migliore P, et al. Cost analysis of endovenous catheter ablation versus surgical stripping for treatment of superficial venous insufficiency and varicose vein disease. J Vasc Surg Venous Lymphat Disord, 2014, 2(1):98-103.
2.	Lynch NP, Clarke M, Fulton GJ. Surgical management of great saphenous vein varicose veins:a meta-analysis. Vascular, 2015, 23(3):285-296.
3.	Gan SJ, Qian SX, Zhang C, et al. Combined subfascial endoscopic perforator surgery and endovenous laser treatment without impact on the great saphenous vein for management of lower-extremity varicose veins. Chin Med J (Engl), 2013, 126(3):405-408.
4.	Burihan MC. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Sao Paulo Med J, 2014, 132(1):69.
5.	Konoeda H, Yamaki T, Hamahata A, et al. Quantification of superficial venous reflux by duplex ultrasound-role of reflux velocity in the assessment the clinical stage of chronic venous insuffi ciency. Ann Vasc Dis, 2014, 7(4):376-382.
6.	劉宏斌, 曹廷寶, 韓曉鵬, 等. 腔內激光聯合Trivex旋切術治療重度下肢淺靜脈曲張的臨床效果. 中國普通外科雜志, 2014, 23(12):1689-1692.
7.	吳田方, 代遠斌, 趙渝. 3種微創手術方法治療大隱靜脈曲張的臨床對比分析. 重慶醫科大學學報, 2012, 37(3):279-282.
8.	Carradice D, Mekako AI, Hatfield J, et al. Randomized clinical trial of concomitant or sequential phlebectomy after endovenous laser therapy for varicose veins. Br J Surg, 2009, 96(4):396-375.
9.	Rasmussen LH, Lawaetz M, Bjoern L, et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg, 2011, 98(8):1079-1087.
10.	李友山, 楊博華. 根據CEAP分級治療下肢靜脈曲張427例. 中國中西醫結合外科雜志, 2015, 21(4):408-410.
11.	劉鵬, 葉志東, 樊雪強, 等. 腔內激光、射頻及內翻剝脫聯合旋切術治療下肢靜脈曲張近期療效的比較. 中華普通外科雜志, 2008, 23(3):171-174.
12.	孔艷杰, 黃樂剛. 靜脈腔內激光閉合術治療大隱靜脈曲張臨床療效分析. 中國現代普通外科進展, 2015, 18(12):968-970.
13.	Rosales-Velderrain A, Gloviczki P, Said SM, et al. Pulmonary embolism after endovenous thermal ablation of the saphenous vein. Semin Vasc Surg, 2013, 26(1):14-22.
14.	Harris EJ. Endovascular obliteration of saphenous vein reflux:a per-spective. J Vasc Surg, 2002, 35(6):1292-1294.
15.	唐言華, 耿協強, 耿玲, 等. 大隱靜脈曲張腔內激光治療術與抽剝術臨床療效比較. 西南國防醫藥, 2009, 19(4):397-398.
16.	Kalteis M, Adelsgruber P, Messie-Werndl S, et al. Five-year results of a randomized controlled trial comparing high ligation combined with endovenous laser ablation and stripping of the great saphenous vein. Dermatol Surg, 2015, 41(5):579-586.
17.	張賢坤, 楊清羽, 劉宏斌, 等. 腔內激光聯合透光旋切系統治療大隱靜脈曲張臨床效果分析. 中國現代手術學雜志, 2015, 19(5):354-357.
18.	祿韶英, 祁光裕, 黃新天, 等. 腔內激光治療下肢淺靜脈曲張并發癥的探討. 中華普通外科雜志, 2006, 21(9):657-659.
19.	閆文鋒, 吳剛, 許延發. 激光腔內閉合術聯合高位結扎術治療大隱靜脈曲張療效觀察. 中華實用診斷與治療雜志, 2015, 29(8):786-787, 790.
20.	馮海, 陳學明, 李晨宇, 等. 剝脫聯合腔內激光治療大隱靜脈曲張. 中華普通外科雜志, 2012, 21(6):664-666.
21.	喻俊彪, 耿協強, 張力峰, 等. 刨吸刀在治療大隱靜脈曲張中的應用(附43例分析). 西南國防醫藥, 2013, 23(2):179-181.
22.	倪良宏, 王祥魁, 趙春燕, 等. 靜脈腔內激光聯合傳統手術改良法治療下肢淺靜脈曲張療效觀察. 中國臨床研究, 2014, 27(5):572-573.
23.	王宏孝, 五新民, 王華龍, 等. 靜脈透光刨吸術聯合大隱靜脈高位結扎術治療下肢靜脈曲張35例. 陜西醫學雜志, 2007, 36(10):1405-1406.
24.	龍運志, 徐勇士, 劉義武, 等. 三種術式治療大隱靜脈曲張臨床療效對比分析. 中國普通外科雜志, 2012, 21(12):1581-1584.

1. Lin JC, Nerenz DR, Migliore P, et al. Cost analysis of endovenous catheter ablation versus surgical stripping for treatment of superficial venous insufficiency and varicose vein disease. J Vasc Surg Venous Lymphat Disord, 2014, 2(1):98-103.
2. Lynch NP, Clarke M, Fulton GJ. Surgical management of great saphenous vein varicose veins:a meta-analysis. Vascular, 2015, 23(3):285-296.
3. Gan SJ, Qian SX, Zhang C, et al. Combined subfascial endoscopic perforator surgery and endovenous laser treatment without impact on the great saphenous vein for management of lower-extremity varicose veins. Chin Med J (Engl), 2013, 126(3):405-408.
4. Burihan MC. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Sao Paulo Med J, 2014, 132(1):69.
5. Konoeda H, Yamaki T, Hamahata A, et al. Quantification of superficial venous reflux by duplex ultrasound-role of reflux velocity in the assessment the clinical stage of chronic venous insuffi ciency. Ann Vasc Dis, 2014, 7(4):376-382.
6. 劉宏斌, 曹廷寶, 韓曉鵬, 等. 腔內激光聯合Trivex旋切術治療重度下肢淺靜脈曲張的臨床效果. 中國普通外科雜志, 2014, 23(12):1689-1692.
7. 吳田方, 代遠斌, 趙渝. 3種微創手術方法治療大隱靜脈曲張的臨床對比分析. 重慶醫科大學學報, 2012, 37(3):279-282.
8. Carradice D, Mekako AI, Hatfield J, et al. Randomized clinical trial of concomitant or sequential phlebectomy after endovenous laser therapy for varicose veins. Br J Surg, 2009, 96(4):396-375.
9. Rasmussen LH, Lawaetz M, Bjoern L, et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg, 2011, 98(8):1079-1087.
10. 李友山, 楊博華. 根據CEAP分級治療下肢靜脈曲張427例. 中國中西醫結合外科雜志, 2015, 21(4):408-410.
11. 劉鵬, 葉志東, 樊雪強, 等. 腔內激光、射頻及內翻剝脫聯合旋切術治療下肢靜脈曲張近期療效的比較. 中華普通外科雜志, 2008, 23(3):171-174.
12. 孔艷杰, 黃樂剛. 靜脈腔內激光閉合術治療大隱靜脈曲張臨床療效分析. 中國現代普通外科進展, 2015, 18(12):968-970.
13. Rosales-Velderrain A, Gloviczki P, Said SM, et al. Pulmonary embolism after endovenous thermal ablation of the saphenous vein. Semin Vasc Surg, 2013, 26(1):14-22.
14. Harris EJ. Endovascular obliteration of saphenous vein reflux:a per-spective. J Vasc Surg, 2002, 35(6):1292-1294.
15. 唐言華, 耿協強, 耿玲, 等. 大隱靜脈曲張腔內激光治療術與抽剝術臨床療效比較. 西南國防醫藥, 2009, 19(4):397-398.
16. Kalteis M, Adelsgruber P, Messie-Werndl S, et al. Five-year results of a randomized controlled trial comparing high ligation combined with endovenous laser ablation and stripping of the great saphenous vein. Dermatol Surg, 2015, 41(5):579-586.
17. 張賢坤, 楊清羽, 劉宏斌, 等. 腔內激光聯合透光旋切系統治療大隱靜脈曲張臨床效果分析. 中國現代手術學雜志, 2015, 19(5):354-357.
18. 祿韶英, 祁光裕, 黃新天, 等. 腔內激光治療下肢淺靜脈曲張并發癥的探討. 中華普通外科雜志, 2006, 21(9):657-659.
19. 閆文鋒, 吳剛, 許延發. 激光腔內閉合術聯合高位結扎術治療大隱靜脈曲張療效觀察. 中華實用診斷與治療雜志, 2015, 29(8):786-787, 790.
20. 馮海, 陳學明, 李晨宇, 等. 剝脫聯合腔內激光治療大隱靜脈曲張. 中華普通外科雜志, 2012, 21(6):664-666.
21. 喻俊彪, 耿協強, 張力峰, 等. 刨吸刀在治療大隱靜脈曲張中的應用(附43例分析). 西南國防醫藥, 2013, 23(2):179-181.
22. 倪良宏, 王祥魁, 趙春燕, 等. 靜脈腔內激光聯合傳統手術改良法治療下肢淺靜脈曲張療效觀察. 中國臨床研究, 2014, 27(5):572-573.
23. 王宏孝, 五新民, 王華龍, 等. 靜脈透光刨吸術聯合大隱靜脈高位結扎術治療下肢靜脈曲張35例. 陜西醫學雜志, 2007, 36(10):1405-1406.
24. 龍運志, 徐勇士, 劉義武, 等. 三種術式治療大隱靜脈曲張臨床療效對比分析. 中國普通外科雜志, 2012, 21(12):1581-1584.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Endovenous Laser Therapy Combined with Planing Aspiration Operation for Great Saphenous Varicose (Experiences of 48 Cases)

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