Liu Peng, Ren Shiyan, Yang Yuguang, Liu Jiangtao, Ye Zhidong, Lin Fan
Department of Surgery, China-Japan Friendship Hospital, Beijing, People's Republic of China.
Int Surg. 2011 Oct-Dec;96(4):331-6. doi: 10.9738/cc44.1.
It is difficult to manage tributary varicose veins with endovenous laser ablation. Using the intravenous catheter-guided laser fiber to ablate the tributary varicose veins has been proposed. From April 2004 to December 2009, we randomly assigned 134 patients with 170 limbs for laser therapy, of which, 89 limbs in 74 patients were treated with laser ablation. The residual tortuous veins were abolished with the intravenous catheter-guided laser ablation (ICLA group), whereas residual varicose veins in 81 limbs in 60 patients were treated by stab avulsion (SA group). Patients were followed up with the median of 44.5 months after surgery. The outcomes and durability of treatment in both groups were evaluated. The primary end point was recurrence of varicose veins. In comparison with the SA group, patients in the ICLA group had fewer surgical incisions and morbidity, a shorter hospital stay, and returned to normal activity earlier. The overall 5-year recurrence of varicose veins was infrequent in the ICLA group but was much higher in the SA group (5.4% versus 20%, P = 0.022). ICLA provided better outcomes than conventional SA in managing the branched varicose veins and may be an alternative for the treatment of branch varicose veins.
采用静脉内激光消融术治疗分支静脉曲张较为困难。有人提出使用静脉导管引导激光纤维来消融分支静脉曲张。2004年4月至2009年12月，我们将134例患者的170条肢体随机分配接受激光治疗，其中74例患者的89条肢体接受了激光消融。残余的迂曲静脉采用静脉导管引导激光消融术治疗（ICLA组），而60例患者的81条肢体中的残余静脉曲张采用点状剥脱术治疗（SA组）。术后对患者进行了中位时间为44.5个月的随访。评估了两组的治疗效果和持久性。主要终点是静脉曲张复发。与SA组相比，ICLA组患者的手术切口和并发症更少，住院时间更短，更早恢复正常活动。ICLA组静脉曲张的总体5年复发率较低，而SA组则高得多（5.4%对20%，P = 0.022）。在处理分支静脉曲张方面，ICLA比传统的SA提供了更好的效果，可能是治疗分支静脉曲张的一种替代方法。
