Lin Peter H, Matos Jesus M, Chen Aaron, Kim Walter, Poi Mun J, Jiang Jenny S, Bechara Carlos F
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA University Vascular Associates, Los Angeles, CA, USA
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Vasc Endovascular Surg. 2016 May;50(4):277-82. doi: 10.1177/1538574416644525. Epub 2016 Apr 25.
Transilluminated powered phlebectomy (TIPP) is a minimally invasive technique of varicose vein removal, which combines irrigated illumination with tumescent anesthesia for ablation of superficial varicosities and endoscopic-powered venous resection. The objective of this study was to analyze treatment outcomes of this treatment modality.
A retrospective evaluation of prospectively collected data from all patients undergoing TIPP procedure for symptomatic varicose veins during a recent 12-year period was performed. Pertinent patient demographics, disease classification, perioperative complications, quality of life, and treatment outcomes were collected and analyzed.
A total of 1167 limbs in 1034 patients (mean age, 52.4 years) were treated during the study period. The mean procedure time was 18.4 ± 8.9 minutes (range, 6.0-82.0 minutes). The mean number of incisions for TIPP procedure was 6.3 ± 3.6. All TIPP procedures were technically successful, and no patient required conversion to hook stab phlebectomy. Fifteen (1.5%) patients developed residual or recurrent varicosities, which were treated with sclerotherapy during the follow-up period. Postoperative complications included hematoma at 2 weeks (5.8%), ecchymosis at 2 weeks (32.9%), saphenous neuropathy (0.3%), cellulitis (1.0%), and skin pigmentation (1.9%). There was no postoperative deep vein thrombosis or mortality.
Transilluminated powered phlebectomy is an effective method for varicose vein removal and is associated with high clinical success and excellent cosmetic results. Meticulous technical steps are critical in achieving successful outcomes while minimizing complications. Technical considerations and lessons learned from our experiences are discussed in this report.
透光动力静脉切除术（TIPP）是一种用于去除静脉曲张的微创技术，它将冲洗照明与肿胀麻醉相结合，用于消融浅表静脉曲张以及内镜动力静脉切除术。本研究的目的是分析这种治疗方式的治疗效果。
对最近12年期间所有因有症状的静脉曲张而接受TIPP手术的患者的前瞻性收集数据进行回顾性评估。收集并分析相关的患者人口统计学、疾病分类、围手术期并发症、生活质量和治疗效果。
在研究期间，共治疗了1034例患者的1167条肢体（平均年龄52.4岁）。平均手术时间为18.4±8.9分钟（范围6.0 - 82.0分钟）。TIPP手术的平均切口数为6.3±3.6个。所有TIPP手术在技术上均获成功，没有患者需要转为钩刺静脉切除术。15例（1.5%）患者出现残余或复发性静脉曲张，在随访期间接受了硬化治疗。术后并发症包括2周时的血肿（5.8%）、2周时的瘀斑（32.9%）、隐神经病变（0.3%）、蜂窝织炎（1.0%）和皮肤色素沉着（1.9%）。没有术后深静脉血栓形成或死亡病例。
透光动力静脉切除术是一种有效的静脉曲张去除方法，具有较高的临床成功率和良好的美容效果。细致的技术步骤对于取得成功结果并将并发症降至最低至关重要。本报告讨论了技术要点以及从我们的经验中吸取的教训。
