Efficacy of subfascial endoscopic perforator surgery combined with endovenous laser closure in the treatment of great saphenous vein varices
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1.Department of Vascular Surgery, Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, China;2.Tongji University School of Medicine, Shanghai 200082, China

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R543.6

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    Abstract:

    Background and Aims Surgery is an effective treatment for great saphenous varicose veins (GSV). However, although traditional perforating vein ligation has demonstrable efficacy, it has many disadvantages, such as relatively large trauma, frequent postoperative complications, and a high postoperative recurrence rate, which increase the risk of secondary treatment. Subfascial endoscopic perforator surgery (SEPS) and endovenous laser treatment (EVLT) are new therapeutic procedures, and each has its advantages. Therefore, this study was performed to investigate the clinical efficacy of EVLT combined with SEPS for the treatment of GSV to provide clinical treatment options.Methods Seventy-eight patients with GSV admitted to Department of Vascular Surgery, Affiliated Hospital of Chengde Medical College from June 2018 to October 2019 were selected and assigned to study group and control group, with 39 cases in each group, using random number table method. Patients in study group underwent SEPS plus EVLT, and those in control group were subjected to conventional perforating vein ligation plus EVLT. The surgical variables, oxidative stress markers, scores for quality of life, incidence of complications and disease recurrence rate were compared between the two groups.Results There were no significant differences in the general data, preoperative levels of oxidative stress markers, and scores for quality of life between the two groups (all P>0.05). The operative time and length of hospital stay were shorter, the intraoperative blood loss and hospitalization costs were less, and the area of petechiae and length of incision on the lower limbs were smaller in study group than those in control group (all P<0.05); the serum levels of malondialdehyde, NO and IL-6 were lower, while glutathione peroxidase was higher at 24 and 72 h after surgery in study group than those in control group (all P<0.05). The scores for psychophysiological state, physical performance, social activity, and pain in study group were superior to those in control group one week after surgery (all P<0.05). The incidence of complications in study group was lower than that in control group (2.56% vs. 20.51%, P<0.05), and the disease recurrence rate on 12 months after surgery in study group was lower than that in the control group (5.56% vs. 26.47%, P<0.05).Conclusion SEPS combined with EVLT for the treatment of GSV has the advantages of less trauma, shorter operative time, faster postoperative recovery, fewer complications, and lower hospitalization costs, as well as improving the patient's quality of life. So, it is recommended to be used in clinical practice.

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WANG Li, ZHANG Hong, DU Jianqing, WU Zhongyin, LI Ronghua, XIAO Yanshang. Efficacy of subfascial endoscopic perforator surgery combined with endovenous laser closure in the treatment of great saphenous vein varices[J]. Chin J Gen Surg,2022,31(12):1636-1643.
DOI:10.7659/j. issn.1005-6947.2022.12.011

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History
  • Received:December 11,2020
  • Revised:May 08,2022
  • Adopted:
  • Online: January 08,2023
  • Published: