Mini-invasive treatment of reticular varicose veins: sclerotherapy, micro-thermocoagulation, cyanoacrylate glue
Journal Title: Хірургія України - Year 2019, Vol 0, Issue 1
Abstract
The aim — to compare the results of reticular varicose veins and telangiectasias treatment depending on used treatment method: sclerotherapy, microthermocoagulation or sclerotherapy with cyanoacrylate glue. Materials and methods. A prospective randomized controlled trial was undertaken in which 78 patients were enrolled. Most of them were females (72), aged 18 — 55 years. Patients were treated with sclerotherapy or microthermocoagulation, or sclerotherapy with cyanoacrylate adhesive. The results of the treatment were compared immediately after procedure, one month and 6 months after it. Results and discussion. The average length of the telangiectasias vascular network decreased more after microthermocoagulation (92.1 %), than after sclerotherapy (by 73.4 %), and adhesive injection (70.7 %) after procedure. The results achieved after the first method were statistically significantly different from two others (p < 0.01). In the group of patients who were treated with sclerotherapy, the total number of relapses during the period of observation was 8 (30.7 %), after microthermocoagulation — 7 (26.9 %) relapses, in case of cyanoacrylate injection — 8 (30.7 %) relapses. The difference between groups is not statistically significant (p = 0.941). In patients who underwent sclerotherapy, 15 (57.7 %) negative local effects were observed, among patients whom microthermocoagulation was performed — 11 (42.3 %) and in the group of patients whom adhesive was injected — 14 (53.8 %). The difference between the groups is not statistically significant (p = 0.518). Pain syndrome prevailed among the negative manifestations in all groups. Its intensity was mild, from 0 to 2. The least level of complains on the unpleasant feelings was in the group of patients who were treated with sclerotherapy, the highest — during microthermocoagulation. The difference between the groups is not statistically significant (p = 0.664). According to the quality of life questionnaire for chronic venous disease (CIVIQ 20), all three methods showed a statistically significant difference in the data before and one month after treatment (p < 0.001 for all groups). Conclusions. The studied methods of reticular varicose veins and telangiectasias treatment are quite safe for patients, the frequency of negative effects and minor local complications do not differ significantly in all groups (p = 0.518). Microthermocoagulation more effectively than injection methods eliminated telangiectasias, the average length of their vascular network decreased by 92.1 % (p < 0.01). It is easier to get obliteration of the reticular veins using sclerotherapy and cyanoacrylate glue injection than using microthermocoagulation with an uninsulated electrode. The number of relapses in a sixmonth period is not high, it was lowest after microthermocoagulation (26.9 %), but the difference was not statistically significant. Quality of life questionnaire for chronic venous disease showed a significant improvement in patients’ selfesteem in a month after treatment (p < 0.001 for all groups).
Authors and Affiliations
V. V. Teplyi, Kh. O. Korolova
Surgery with minimally invasive technologies for acute infected pancreatic necrosis in an elderly patient. Case report
One of the main problems in the treatment of pancreatic necrosis continues to be the choice of the most rational surgical tactics. The wide use of minimally invasive technologies in the complex treatment of acute pancrea...
Surgical treatment of giant incisional ventral hernias with modified polypropylene mesh
The aim — to improve the results of surgical treatment of giant incisional ventral hernias (GIVH) with the Ramirez operation in combination with modified polypropylene mesh. Materials and methods. The surgical treatment...
Analysis of simultaneous operations in patients with hyperglycemia
The aim — to identify and evaluate simultaneous gynaecological and abdominal operations in a retrospective cohort of patients aged 55 years and older with impaired glucose tolerance. Materials and methods. All patients...
Surgical treatment of gynecomastia and pseudo-gynecomastia
The aim — to evaluate and analyze the surgical treatment results of patients with varying degrees of gynecomastia and pseudo‑gynecomastia. Materials and methods. 62 patients were under our supervision: with gynecomastia...
A combination of minimally invasive treatment for varicose disease of the lower extremities
The aim — to compare the effectiveness of the combined phlebectomy with endovenous laser coagulation (EVLC) with bare‑tip laser fiber and the simultaneous endovenous chemical ablation of the GSV trunk in comparison with...