ObjectiveTo evaluate optimal surgical timing of high ligation and ambulatory phlebectomy in treatment of primary great saphenous varicose vein. MethodsThe patients who met the inclusion criteria were divided into simple varicose vein (C2) group and soft tissue complications (C3-C4) group.All the patients were received high ligation and ambulatory phlebectomy.The surgery-related indexes,hospital costs,improvement of quality of life,postoperative recurrence rate were observed. ResultsAll the operations were successful.The operative time,the number of operative incision,and the hospital costs in the C2 group were significantly less than those in the C3-C4 group (P<0.05).The total postoperative complications rate in the C2 group was significantly lower than that in the C3-C4 group (P<0.05).The postoperative AVVQ score on month 3 in the C2 group was significantly lower than that in the C3-C4 group (P<0.05).The postoperative recurrence rate on month 3 had no statistical significance between these two groups (P>0.05). ConclusionsEarly stage (C2) is the optimal surgical timing of primary great saphenous varicose vein,benefits of surgery and health economics in early stage are significantly better than those in mid-advanced stage (C3-C4).It is suggested that surgery should be underwent at early stage in patients with primary great saphenous varicose vein.
Objective To compare scar and incision satisfaction between Prolene polypropylene suture and conventional silk suture for dermal suture in high ligation and stripping of primary great saphenous varicose vein. Methods A total of 83 patients who met the inclusion criteria were admitted in the West China Hospital, including 27 males and 56 females. The average age was 46.7 years old, ranging from 30 to 63 years old. Forty-two patients were grade C2 and 41 were grade C3 according to the CEAP grading. Patients were divided into a polypropylene suture group (even number,n=45) and a silk suture group (odd number,n=38) according to admission date order. Prolene 5-0 polypropylene suture was used for dermal suture in the patients of the polypropylene suture group and 1# silk suture in the patients of the silk suture group. The pigments of incision area and suture area and their widths, and the points of Patient and Observer Scar Assessment Scale score (POSAS) and patient and observer satisfaction score of incision were observed on month 6 for following-up. Results ① The gender, age, body mass index, and proportion of C2 of the CEAP grading or smoking had no significant difference between these two groups (P>0.05). ② All the operations were successful and all the patients were followed up. All the incisions healed well and had no infection. There was a few subcutaneous hematoma in one incisionof the 2 patients on day 3 after operation in the two groups, which markedly improved after dressing treatment. The sutures of all the patients were removed on day 14 after operation. ③ The pigment of incision area and its width, and the points of POSAS had no significant differences between the two groups (P>0.05). The pigment of suture area and its width, and the points of patient and observer satisfaction score of the incision in the polypropylene suture group were significantly better than those in the silk suture group (P<0.05). Conclusion Prolene polypropylene suture is preference to conventional silk suture in aesthetic results and patient satisfaction for dermal suture of great saphenous varicose vein surgery.
Objective To compare the effect of high ligation and spot stripping (HLSS) and high ligation and foam sclerotherapy (HLFS) in the treatment of great saphenous varicose veins (GSVV). Methods A retrospective analysis was conducted on the clinical data of 385 patients with GSVV who received HLFS or HLSS treatment at Guizhou Provincial People’s Hospital from January 2018 to June 2022. The differences in surgical time, intraoperative bleeding, complications, and postoperative hospital stay between the two groups were compared. Results The surgical time, intraoperative bleeding, postoperative hospital stay, visual analog scale for pain, incidence of postoperative hematoma, skin sensory disorders, and infection in the HLFS group were less or lower than those in the HLSS group (P<0.05), but there was no statistically significant difference in recurrence rate between the two groups (P>0.05). Compared with preoperative indicators at the same group, the modified venous clinical severity score (VCSS) decreased and the chronic lower limb venous insufficiency questionnaire (CIVIQ) score increased (P<0.05). However, there was no statistically significant difference in the degree of improvement in VCSS and CIVIQ between the two groups at three months after surgery and before surgery (P>0.05). Conclusions HLFS has a definite therapeutic effect on GSVV, with smaller trauma, faster recovery after surgery, and lower incidence of postoperative complication compared to HLSS. It can be used as a surgical option for GSVV patients in clinical practice.