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J Vasc Surg Venous Lymphat Disord ; 10(2): 370-375, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34438089

RESUMEN

BACKGROUND: Technical errors are the most common preventable cause of recurrence after high ligation and stripping procedures for the treatment of great saphenous vein incompetence. Ultrasound-assisted varicose vein surgery (UAVS) uses intraoperative ultrasound during high ligation and stripping to minimize such failures, although no data have been reported regarding its use during open surgery. The present study compared the short-term outcomes of UAVS and endovenous laser ablation (EVLA) with a 1470-nm laser. METHODS: The present prospective randomized study was conducted from January 2019 to December 2019. We compared 40 patients who had undergone UAVS under regional anesthesia with an equal number of patients who had undergone EVLA under tumescent anesthesia. Both groups received 1 week of standardized postoperative analgesia. The improvements in the pain score, venous clinical severity score, and recurrence at 6 months and 1 year were studied. RESULTS: No significant differences were found in either clinical or radiologic great saphenous vein recurrence after UAVS compared with EVLA at 1 year. The mean pain score at 8 hours after the procedure was higher in the UAVS group (3.7 ± 1.2 vs 2.9 ± 1.0; P = .03). At 1 week, the score was higher in the EVLA group (1.8 ± 0.7 vs 1.4 ± 0.5; P = .01). At 6 months, the venous clinical severity score had improved from 9.2 ± 3.7 to 2.4 ± 1.4 in the UAVS group and from 9.3 ± 3.2 to 2.1 ± 0.8 in the EVLA group (P = .64). At 1 year, the corresponding scores were 1.3 ± 0.7 and 1.4 ± 0.6 (P = .21). CONCLUSIONS: UAVS has high technical success, making it a suitable alternative to EVLA using a 1470-nm laser.


Asunto(s)
Terapia por Láser , Vena Safena/cirugía , Ultrasonografía Intervencional , Várices/cirugía , Procedimientos Quirúrgicos Vasculares , Insuficiencia Venosa/cirugía , Adulto , Anciano , Femenino , Humanos , India , Terapia por Láser/efectos adversos , Ligadura , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Valor Predictivo de las Pruebas , Estudios Prospectivos , Recurrencia , Vena Safena/diagnóstico por imagen , Vena Safena/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Várices/diagnóstico por imagen , Várices/fisiopatología , Procedimientos Quirúrgicos Vasculares/efectos adversos , Insuficiencia Venosa/diagnóstico por imagen , Insuficiencia Venosa/fisiopatología , Adulto Joven
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