BACKGROUND: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. METHODS: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. RESULTS: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. CONCLUSION: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.
Humans ; Leg ; Ligation* ; Postoperative Complications ; Recurrence ; Saphenous Vein* ; Varicose Veins

BACKGROUND: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. MATERIAL AND METHOD: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. RESULT: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. CONCLUSION: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.
Extremities ; Follow-Up Studies ; Humans ; Ligation ; Paresthesia ; Postoperative Complications ; Saphenous Vein ; Varicose Veins ; Veins ; Venous Thrombosis

Adult ; Female ; Humans ; Pulmonary Veins ; abnormalities ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Varicose Veins ; complications ; diagnosis

OBJECTIVES: Our retrospective study was designed to examine the efficacy of endovenous laser ablation (ELA) in patients with varicose vein. METHODS: One hundred and twenty-five patients (157 limbs) underwent ELA from June 2008 to June 2011. Age of patients, sex, location of lesions, postoperative complications and recurrence rate were analyzed. Follow up was performed by 1week, 4weeks and 8weeks after operation. RESULTS: The mean age of patients was 51.4 years old and men and women were 73 and 52. The prevalence of minor complications was 14.4% and the recurrence rate was 3.2%. CONCLUSIONS: ELA of the varicose vein is effective and safe methods. ELA is simple to perform, relatively atraumatic and well accepted by patients. In my opinion, ELA can be effectively implemented in surgical practice.
Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Postoperative Complications ; Prevalence ; Recurrence ; Retrospective Studies ; Varicose Veins

PURPOSE: Endovenous laser treatment (EVLT) has been performed as a minimally invasive alternative to conventional surgery for saphenous vein incompetence. It is thought to minimize postoperative complications and improve the quality of life compared with high ligation and stripping. The aim of this retrospective study was to compare the postoperative complications and quality of life of EVLT with high ligation and stripping (HS). METHODS: A total of 294 patients with 390 saphenous veins were included in this study. Patients with saphenous vein incompetence were treated with either HS (n=98; HS group) or EVLT (n=196; EVLT group). Patients were evaluated preoperatively and at 1, 3 months, postoperatively. Postoperative complications, the Venous Clinical Severity Score (VCSS) and the Aberdeen Varicose Vein Symptom Severity Score (AVSS) were compared between the two groups. RESULTS: The total postoperative complication rate was 31.62%, in HS and 27.47% in the EVLT groups. Most of the complications were minor and self-limited. There were no statistical differences in the total complication rate and the occurrence of complications such as hematoma, paresthesia and phlebitis. Pain was less severe following EVLT compared to HS. The EVLT patients were discharged and resumed their normal activity earlier than the HS patients. The two groups had similar improvement of the VCSS and AVSS at 1 and 3 months, postoperatively. CONCLUSION: With the similar, comparable short-term safety outcome, both HS and EVLT may be considered as safe procedures for the treatment of varicose veins. Long-term, large population-based randomized studies with promising data for the improvement of quality of life scores will be needed for the evaluation of EVLT before it becomes a standard treatment for saphenous vein incompetence.
Hematoma ; Humans ; Ligation ; Paresthesia ; Phlebitis ; Postoperative Complications ; Quality of Life ; Retrospective Studies ; Saphenous Vein ; Varicose Veins

OBJECTIVE: To observe the effect of subfascial endoscopic perforator vein surgery (SEPS) in the treatment of chronic venous ulceration of the legs. METHODS: Chronic venous ulceration for 91 patients with 102 limbs was treated by SEPS from January 2005 to July 2008. The effect of SEPS on chronic venous ulceration of the leg, the symptoms during and after the operation, and the durations of hospital treatment were analyzed. RESULTS: The symptoms of the 102 legs conducted by SEPS operation, except the pigmentation, were obviously improved (P<0.01). Its cicatrisation rate, the recrudesce rate, and the cut infection rate were 93.1%, 1.96%, and 1.0%, respectively. The time of the operation was short and the hemorrhage was small during the surgery. The durations of hospitalization and the cicatrisation time of ulceration were (6.5+/-3.4) d and (12.2+/-13.7) d, respectively. CONCLUSION SEPS is simple and effective in treating chronic venous ulceration of the leg, and particularly effective for patients classified into C5 and C6 in clinical-etiological-anatomical-pathophysiology (CEAP).
Aged ; Angioscopy ; methods ; Fasciotomy ; Female ; Humans ; Male ; Middle Aged ; Varicose Ulcer ; surgery ; Varicose Veins ; surgery ; Vascular Surgical Procedures ; Venous Insufficiency ; complications ; surgery

Objective: To investigate the effects of primary preventive treatment under endoscope for esophageal and gastric varices on bleeding rate and its relevant factors. Methods: 127 cases with liver cirrhosis accompanied with esophageal and gastric varices without bleeding history were included in the endoscopic and non-endoscopic treatment group, respectively. Informed consent was obtained from both groups. Gastric varices (Lgf) and esophageal varices (Leg) were diagnosed according to LDRf classification criteria, and the corresponding treatment scheme was selected according to the recommended principle of this method.The incidence rate of bleeding from ruptured esophageal varices were observed at 3, 6 months, and 1, and 2 years in the treated and the untreated group, and the patients with different Child-Pugh scores were followed-up for 2 years. Gender, age, etiology, varicose degree, Child-Pugh grade, platelet count, prothrombin activity, portal vein thrombosis, collateral circulation, portal vein width and other factors affecting the bleeding rate were assessed. Measurement data were described as mean ± standard deviation (x¯±s), and qualitative data of categorical variables were expressed as percentage (%), and χ² test was used. Results: 127 cases were followed up for 2 years. There were 55 cases in the endoscopic treatment group (18 cases underwent band ligation, 2 cases underwent band ligation combined with tissue adhesive embolization, 28 cases underwent sclerotherapy, and 7 cases underwent sclerotherapy combined with tissue adhesive embolization). Recurrent bleeding and hemorrhage was occurred in 5 (9.1%) and 28 cases (38.9%), respectively (P<0.05). In addition, there were 72 cases in the untreated group (P<0.05). Severe varicose veins proportions in treated and untreated group were 91.1% and 85.1%, respectively (P>0.05). There was no statistically significant difference in liver cirrhosis-related medication and β-blocker therapy between the treated and untreated group (P>0.05). There was no statistically significant difference in the bleeding rate between the different treated groups (P>0.05). The bleeding rates at 3, 6 months, 1, and 2 years in endoscopic treated and untreated group were 2.00% vs. 2.59% (P>0.05), 2.30% vs. 5.88% (P>0.05), 3.10% vs. 7.55% (P>0.05) and 4.00% vs. 21.62% (P<0.05), respectively. All patients with Child-Pugh grade A, B and C in the treated and the untreated group were followed-up for 2 years, and the bleeding rates were 1.8% vs. 8.1% (P<0.05), 1.1% vs. 9.4% (P<0.05) and 9.1% vs. 10.1% (P>0.05), respectively. There were statistically significant differences in the rupture and bleeding of esophageal and gastric varices, varices degree, Child-Pugh grade and presence or absence of thrombosis formation in portal vein (P<0.05); however, no statistically significant differences in gender, age, etiology, platelet count, prothrombin activity, collateral circulation and portal vein width (P>0.05). There was no intraoperative bleeding and postoperative related serious complications in the treated group. Conclusion: The risk of initial episodes of bleeding from esophageal and gastric varices is significantly correlated with the varices degree, Child-Pugh grade, and portal vein thrombosis. Primary preventive treatment under endoscope is safe and effective for reducing the long-term variceal bleeding risk from esophageal and gastric varices.
Endoscopes ; Esophageal and Gastric Varices/complications* ; Gastrointestinal Hemorrhage/surgery* ; Humans ; Hypertension, Portal/complications* ; Ligation ; Liver Cirrhosis/complications* ; Prothrombin ; Sclerotherapy ; Tissue Adhesives ; Varicose Veins ; Venous Thrombosis/complications*

BACKGROUND: Endovenous laser treatment has recently been introduced as a less invasive technique, with many good results reported. A 980-nm diode laser was used on the great saphenous vein (GSV) occlusions in patients with varicose veins, due to GSV reflux, and the therapeutic effects analyzed. MATERIAL AND METHOD: Between September 2003 and February 2006, 238 patients (332 cases) with GSV reflux underwent endovenous laser treatment with a 980-nm diode laser. Operative procedures were simultaneous endovenous laser treatment and ambulatory phlebectomy. The preoperative clinical findings, postoperative complications and postoperative duplex US follow up results at 1 and 3 months were reviewed. RESULT: Postoperative complications were ecchymosis in almost cases, paresthesia 68 cases (20.5%) and skin burn in 3 cases (0.9%). Follow up duplex US revealed 26 and 10 cases at 1 and 3 months of GSV reflux or partial recanalization, with therapeutic success rates of 91.3 and 87.9%, respectively. CONCLUSION: The treatment of GSV occlusion with an endovenous laser is less invasive than traditional GSV stripping, but relatively high recanalization was experienced, possibly due to inadequate laser power, laser fiber pullback speed or an extremely dilated GSV. However, continuous attempts will be required to reduce the recanalization after the procedure, with accurate follow up using duplex US.
Burns ; Ecchymosis ; Follow-Up Studies ; Humans ; Lasers, Semiconductor* ; Paresthesia ; Postoperative Complications ; Saphenous Vein* ; Skin ; Surgical Procedures, Operative ; Varicose Veins

BACKGROUND: To determine the efficacy and safety of endoscopic resection and ablation of superficial varicosities using a powered vein resector, irrigated illuminator. MATERIAL AND METHOD: 83 consecutive patients were involved in the study. 103 limbs in 83 patients were treated using a minimal invasive, powered, vein resecting device with cutaneous transillumination and tumescent anesthesia technique. There were 51 women and 32 men. All patients were operated under general anesthesia or regional anesthesia. Operative time and patient satisfaction scores were recorded along with the number of incisions made. RESULT: 83 patients(51/61.4% female, 32/38.6% male, aged 25-78 years) had varicose vein. Average age at the time of operation was 45 years(range, 25 to 78 years). There were 63 unilateral procedures and 20 bilateral operations. Operative time ranged from 24 to 46 minutes (average 35.3 minutes) in the unilateral procedure. The number of incisions per limb averaged 2.7(range, 2 to 5). Postoperative complications occurred in 7(8.4%) patients. Patients were asked to describe their pain on an analog scale ranging from 1 to 10 with 1 representing no pain and 10 worst imaginable pain. Immediately postoperative pain score was 2.4. Postoperative pain score at 72 hours had a mean score of 2.0. Postoperative pain score at 1 months were 1. CONCLUSION: Varicose vein removal using Transilluminated Powered Phlebectomy(TIPP) is a safe and efficient procedure. The procedure saves time, is easy to perform, and gives direct visualization and a distinct endpoint of the removal of veins. It is also less tedious to perform and gives good cosmetic results with significant pain relief.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Extremities ; Female ; Humans ; Male ; Operative Time ; Pain, Postoperative ; Patient Satisfaction ; Postoperative Complications ; Surgical Procedures, Minimally Invasive ; Transillumination ; Varicose Veins* ; Veins

PURPOSE: To determine the efficacy and safety of endoscopic resection and ablation of superficial varicose vein using a powered vein resector and irrigated illuminator. METHODS: Forty-three limbs in 29 patients were involved in our hospital study. The clinical records between August 2002 and February 2004 were reviewed. All patients were treated with a minimally invasive, powered vein resecting device, using cutaneous transillumination and tumescent fluid under general or spinal anesthesia. RESULTS: The 29 varicose vein patients were composed, (19 men (65.5%) and 10 women (34.5%), with a mean age of 56.9 years. The most common symptom or sign of varicose vein was an unsightly vein (15 patients, 51.7%). Fifteen unilateral (5: right, 10: left) and 14 bilateral operation for varicose veins were performed. The mean operative time, number of skin incisions and length of hospital stay were 34.2 minutes, (ranging from 26 to 58, 3.2 sites, (ranging form 2 to 6) and 3.3 days, (ranging from 2 to 6). Postoperative complications occurred in 12 limbs (27.9%), including skin perforation (1 limb, 2.3%), wound abscess (1 limb, 2.3%), cellulitis (1 limb, 2.3%), lower limb pain (4 limbs, 9.3%), edema (2 limbs, 4.7%), hematoma (1 limb, 2.3%), remaining varicose vein (1 limb, 2.3%) and paresthesia (1 limb, 2.3%). CONCLUSION: This study showed that the TIPP (TriVexTM) technique for varicose vein removal was swift and efficacious. When performed by trained surgeons the complication rates of the technique were comparable with those of conventional surgery, with the advantages of a trend toward reduced operating times in extensive varicose vein, and significantly fewer incisions.
Abscess ; Anesthesia, Spinal ; Cellulitis ; Edema ; Extremities ; Female ; Hematoma ; Humans ; Length of Stay ; Lower Extremity* ; Male ; Operative Time ; Paresthesia ; Postoperative Complications ; Skin ; Transillumination ; Varicose Veins* ; Veins ; Wounds and Injuries