Combinative Use of Radiofrequency and Transilluminated Powered Phlebectomy in Treatment of Varicose Veins of Lower Extremity_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Guokai , YANG Yong , HE Xiaoming , LUO Kaiyuan , WAN Jia , YANG Guang , LI Guojian , MA Zhenghuan , LU Ping.

Yunnan Province Center of Vascular Surgery, Department of Vascular Surgery， The Second Peoples Hospital of Yunnan Province, Kunming 650021, China Corresponding Author： YANG Guo-kai， E-mail： yguokai@sina.com;

Corresponding author：

Keywords：

Varicose veins of lower extremity; Phlebectomy; Complications

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Objective To evaluate the efficiency and safety of combinative use of radiofrequency and transilluminated powered phlebectomy for treatment of varicose veins of lower extremity. Methods Three hundred and twenty-one cases of varicose veins of lower extremity were randomly divided into three groups: group A (102 cases)： endovenouser whole range closure in situ for great saphenous vein by radiofrequency and transilluminated powered phlebectomy for varicose veins of leg; group B (97 cases)： endovenouser whole range closure in situ for upper leg part of great saphenous vein by radiofrequency and transilluminated powered phlebectomy for varicose veins of leg; 122 conventional treatment cases, which high ligation and stripping of great saphenous vein, blood vessel branches and communicating branches resection and ligation were used, were selected as controlled group (group C). Consequences and complications of operation were checked. Results In all cases, the symptoms of swelling in lower extremity, soreness and infirmity disappeared within one month after operation, skin pigmentation was alleviated within one month after operation, and disappeared gradually within three months. Contrasting three groups in complications of skin numbness of legs, ecchymosis of upper leg, wound hematoma, and swelling below ankle, there was no statistical difference between group A and B, and there was statistical difference between group A and C, and B and C. There were more complications in conventional group than those in mini-invasive groups. There was no statistical difference in leg ecchymosisa between group B and C. No deep vein thrombosis of lower extremity and incision infection was detected in all cases. Conclusion It is simple and definitely efficient to combine radiofrequency with transilluminated powered phlebectomy for treatment of varicose veins of lower extremity. Powered phlebectomy is efficient in removal of varicose vein, but not suitable for phlebectomy for trunk of great saphenous vein.

Citation： YANG Guokai,YANG Yong,HE Xiaoming,LUO Kaiyuan,WAN Jia,YANG Guang,LI Guojian,MA Zhenghuan,LU Ping.. Combinative Use of Radiofrequency and Transilluminated Powered Phlebectomy in Treatment of Varicose Veins of Lower Extremity. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(1): 60-63. doi: Copy

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10.	Bergan JJ. Venous insufficiency and perforating veins [Ｊ] . Br J Surg, 1998； 85(2)： 721.
11.	Dunst KM, Huemer GM, Wayand W, et al . Diffuse phlegmonous phlebitis after endovenous laser treatment of the greater saphenous vein [Ｊ] . J Vasc Surg， 2006； 43(5)： 1056.
12.	Ting ACW, Cheng SWK, Ho P, et al . Clinical outcomes and changes in venous hemodynamics after subfascial endoscopic perforating vein surgery [Ｊ] . Surg Endosc， 2003； 17(1)： 1314.
13.	Viarengo LM, Potério-Filho J, Potério GM, et al . Endovenous laser treatment for varicose veins in patients with active ulcers: measurement of Intravenous and perivenous temperatures during the procedure [Ｊ] . Dermatologic Surgery, 2007； 33(10)：1234.
14.	Salles-Cunha SX, Comerota AJ， Tzilinis A, et al . Ultrasound findings after radiofrequency ablation of the great saphenous vein: descriptive analysis [Ｊ] . J Vasc Surg, 2004； 40(6)： 1166.
15.	Fassiadis N, Kianifrad B, Holdstock JM, et al . A novel endoluminal technique for varicose vein management: the VNUS closure [Ｊ] . Phlebology, 2002； 16(1)： 145.
16.	陈开，刘崇清，戴毅, 等. 应用微创刨吸术治疗下肢静脉曲张52例报告 [Ｊ] . 中国普外基础与临床杂志, 2005； 12（5）：515.
17.	张望德，苑超，邢彤，等. TriVex微创旋切术治疗下肢静脉曲张的临床分析 [Ｊ] . 中华外科杂志， 2006； 44（9）：588.
18.	孙镇蛟，金旭文，林森旺，等. 大隐静脉曲张刨吸术53 例报告 [Ｊ] . 中国微创外科杂志, 2006； 6(6)： 463.
19.	殷恒讳，王深明，叶财盛，等. 两种微创手术方式治疗单纯性下肢静脉曲张的疗效比较 [Ｊ] . 中国实用外科杂志， 2006； 26（10）： 772.

1. Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of lower extremities: The “CEAP” Classification [Ｊ] . Mayo Clin Proc, 1996； 71(3)： 338 2 Labropoulos N, Patel PJ, Tiongson JE, et al . Patterns of venous reflux and obstruction in patients with skin damage due to chronic venous disease [Ｊ] . Vasc Endo Surg, 2007； 41(1)： 33.
2. 张柏根. 下肢慢性静脉功能不全与CEAP分类系统 [Ｊ] . 外科理论与实践， 2005； 10（1）： 1.
3. 杨国凯，杨镛，罗开元，等. 激光与射频腔内闭合治疗下肢静脉曲张 [Ｊ] . 中国现代普通外科进展， 2007； 10（2）： 173.
4. 杨国凯，杨镛，罗开元，等. 射频消融治疗下肢静脉曲张 [Ｊ] . 云南医药， 2007； 28（3）：213.
5. 叶志东，刘鹏，王非，等. 下肢静脉曲张微创治疗的思考与评价 [Ｊ] . 中国实用外科杂志， 2006； 26（10）： 775.
6. Stanley JG, Barnes RW, Ernst CB, et al . Vascular surgery in the united states: workforce issues [Ｊ] . J Vasc Surg, 1996； 23(2)： 172.
7. Kalra M, Gloviszki P. Surgical treatment of venous ulcers： role of subfascial endoscopic perforator vein ligation [Ｊ] . SCAN， 2003； 83(3)： 1.
8. McLafferty RB, Lohr JM, Caprini JA, et al . Results of the national pilot screening program for venous disease by the American Venous Forum [Ｊ] . J Vasc Surg, 2007； 45(1)： 142.
9. 王磊，侯宝忠，于威，等. 外科治疗原发性下肢静脉曲张 [Ｊ] . 中国普外基础与临床杂志, 2007; 14(5)： 605.
10. Bergan JJ. Venous insufficiency and perforating veins [Ｊ] . Br J Surg, 1998； 85(2)： 721.
11. Dunst KM, Huemer GM, Wayand W, et al . Diffuse phlegmonous phlebitis after endovenous laser treatment of the greater saphenous vein [Ｊ] . J Vasc Surg， 2006； 43(5)： 1056.
12. Ting ACW, Cheng SWK, Ho P, et al . Clinical outcomes and changes in venous hemodynamics after subfascial endoscopic perforating vein surgery [Ｊ] . Surg Endosc， 2003； 17(1)： 1314.
13. Viarengo LM, Potério-Filho J, Potério GM, et al . Endovenous laser treatment for varicose veins in patients with active ulcers: measurement of Intravenous and perivenous temperatures during the procedure [Ｊ] . Dermatologic Surgery, 2007； 33(10)：1234.
14. Salles-Cunha SX, Comerota AJ， Tzilinis A, et al . Ultrasound findings after radiofrequency ablation of the great saphenous vein: descriptive analysis [Ｊ] . J Vasc Surg, 2004； 40(6)： 1166.
15. Fassiadis N, Kianifrad B, Holdstock JM, et al . A novel endoluminal technique for varicose vein management: the VNUS closure [Ｊ] . Phlebology, 2002； 16(1)： 145.
16. 陈开，刘崇清，戴毅, 等. 应用微创刨吸术治疗下肢静脉曲张52例报告 [Ｊ] . 中国普外基础与临床杂志, 2005； 12（5）：515.
17. 张望德，苑超，邢彤，等. TriVex微创旋切术治疗下肢静脉曲张的临床分析 [Ｊ] . 中华外科杂志， 2006； 44（9）：588.
18. 孙镇蛟，金旭文，林森旺，等. 大隐静脉曲张刨吸术53 例报告 [Ｊ] . 中国微创外科杂志, 2006； 6(6)： 463.
19. 殷恒讳，王深明，叶财盛，等. 两种微创手术方式治疗单纯性下肢静脉曲张的疗效比较 [Ｊ] . 中国实用外科杂志， 2006； 26（10）： 772.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Combinative Use of Radiofrequency and Transilluminated Powered Phlebectomy in Treatment of Varicose Veins of Lower Extremity

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