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.	刘宏斌, 曹廷宝, 韩晓鹏, 等. 腔内激光联合Trivex旋切术治疗重度下肢浅静脉曲张的临床效果. 中国普通外科杂志, 2014, 23(12):1689-1692.
7.	吴田方, 代远斌, 赵渝. 3种微创手术方法治疗大隐静脉曲张的临床对比分析. 重庆医科大学学报, 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, 杨博华. 根据CEAP分级治疗下肢静脉曲张427例. 中国中西医结合外科杂志, 2015, 21(4):408-410.
11.	刘鹏, 叶志东, 樊雪强, 等. 腔内激光、射频及内翻剥脱联合旋切术治疗下肢静脉曲张近期疗效的比较. 中华普通外科杂志, 2008, 23(3):171-174.
12.	孔艳杰, 黄乐刚. 静脉腔内激光闭合术治疗大隐静脉曲张临床疗效分析. 中国现代普通外科进展, 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.	唐言华, 耿协强, 耿玲, 等. 大隐静脉曲张腔内激光治疗术与抽剥术临床疗效比较. 西南国防医药, 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.	张贤坤, 杨清羽, 刘宏斌, 等. 腔内激光联合透光旋切系统治疗大隐静脉曲张临床效果分析. 中国现代手术学杂志, 2015, 19(5):354-357.
18.	禄韶英, 祁光裕, 黄新天, 等. 腔内激光治疗下肢浅静脉曲张并发症的探讨. 中华普通外科杂志, 2006, 21(9):657-659.
19.	闫文锋, 吴刚, 许延发. 激光腔内闭合术联合高位结扎术治疗大隐静脉曲张疗效观察. 中华实用诊断与治疗杂志, 2015, 29(8):786-787, 790.
20.	冯海, 陈学明, 李晨宇, 等. 剥脱联合腔内激光治疗大隐静脉曲张. 中华普通外科杂志, 2012, 21(6):664-666.
21.	喻俊彪, 耿协强, 张力峰, 等. 刨吸刀在治疗大隐静脉曲张中的应用(附43例分析). 西南国防医药, 2013, 23(2):179-181.
22.	倪良宏, 王祥魁, 赵春燕, 等. 静脉腔内激光联合传统手术改良法治疗下肢浅静脉曲张疗效观察. 中国临床研究, 2014, 27(5):572-573.
23.	王宏孝, 五新民, 王华龙, 等. 静脉透光刨吸术联合大隐静脉高位结扎术治疗下肢静脉曲张35例. 陕西医学杂志, 2007, 36(10):1405-1406.
24.	龙运志, 徐勇士, 刘义武, 等. 三种术式治疗大隐静脉曲张临床疗效对比分析. 中国普通外科杂志, 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. 刘宏斌, 曹廷宝, 韩晓鹏, 等. 腔内激光联合Trivex旋切术治疗重度下肢浅静脉曲张的临床效果. 中国普通外科杂志, 2014, 23(12):1689-1692.
7. 吴田方, 代远斌, 赵渝. 3种微创手术方法治疗大隐静脉曲张的临床对比分析. 重庆医科大学学报, 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, 杨博华. 根据CEAP分级治疗下肢静脉曲张427例. 中国中西医结合外科杂志, 2015, 21(4):408-410.
11. 刘鹏, 叶志东, 樊雪强, 等. 腔内激光、射频及内翻剥脱联合旋切术治疗下肢静脉曲张近期疗效的比较. 中华普通外科杂志, 2008, 23(3):171-174.
12. 孔艳杰, 黄乐刚. 静脉腔内激光闭合术治疗大隐静脉曲张临床疗效分析. 中国现代普通外科进展, 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. 唐言华, 耿协强, 耿玲, 等. 大隐静脉曲张腔内激光治疗术与抽剥术临床疗效比较. 西南国防医药, 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. 张贤坤, 杨清羽, 刘宏斌, 等. 腔内激光联合透光旋切系统治疗大隐静脉曲张临床效果分析. 中国现代手术学杂志, 2015, 19(5):354-357.
18. 禄韶英, 祁光裕, 黄新天, 等. 腔内激光治疗下肢浅静脉曲张并发症的探讨. 中华普通外科杂志, 2006, 21(9):657-659.
19. 闫文锋, 吴刚, 许延发. 激光腔内闭合术联合高位结扎术治疗大隐静脉曲张疗效观察. 中华实用诊断与治疗杂志, 2015, 29(8):786-787, 790.
20. 冯海, 陈学明, 李晨宇, 等. 剥脱联合腔内激光治疗大隐静脉曲张. 中华普通外科杂志, 2012, 21(6):664-666.
21. 喻俊彪, 耿协强, 张力峰, 等. 刨吸刀在治疗大隐静脉曲张中的应用(附43例分析). 西南国防医药, 2013, 23(2):179-181.
22. 倪良宏, 王祥魁, 赵春燕, 等. 静脉腔内激光联合传统手术改良法治疗下肢浅静脉曲张疗效观察. 中国临床研究, 2014, 27(5):572-573.
23. 王宏孝, 五新民, 王华龙, 等. 静脉透光刨吸术联合大隐静脉高位结扎术治疗下肢静脉曲张35例. 陕西医学杂志, 2007, 36(10):1405-1406.
24. 龙运志, 徐勇士, 刘义武, 等. 三种术式治疗大隐静脉曲张临床疗效对比分析. 中国普通外科杂志, 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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