Department of Surgery, Institute of Postgraduate Education, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
Second Department of Internal Medicine, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
J Med Life. 2022 Apr;15(4):563-569. doi: 10.25122/jml-2021-0318.
There are problems of postoperative relapse of veins after radiofrequency ablation (RFA). The study aims to analyze the causes of postoperative recurrence of veins after RFA. 928 patients with varicose veins of the lower extremities, clinical classes C-C according to the CEAP classification, were treated in the ambulatory surgery centers using RFA. The causes of varicose recurrence showed that it was caused by: a) high fusion of the anterior accessory great saphenous vein (AAGSV) with great saphenous vein (GSV) directly in the saphenofemoral junction (SFJ), which was not revealed by preoperative ultrasound (1.7%); a long stump of the GSV after the RFA (7.8%); progression of varicose disease with the small saphenous vein (SSV) and formation of new reflux associated with insufficiency of the saphenopopliteal junction (SPJ) (4.7%); d) insufficiency of perforating veins of the tibioperoneal group (Sherman, Boyd), as well as Gunter (3.8%); e) neovascularization with dilation of small vessels in the area of the saphenofemoral junction (0.97%). A comparative assessment of the quality of life (QL) after different surgery methods 3 years after implementation was carried out. Thus, QL in all patients who underwent surgery significantly improved than before surgery. However, after the RFA GSV+AAGSV, the patients had better QL by all scales than those who underwent only RFA GSV. Operations performed simultaneously on GSV and AAGSV have better functionality than GSV-only RFA.
射频消融（RFA）后静脉的术后复发存在问题。本研究旨在分析 RFA 后静脉复发的原因。928 例下肢静脉曲张患者，临床 CEAP 分级 C-C 级，在日间手术中心采用 RFA 治疗。静脉曲张复发的原因表明，这是由以下原因引起的：a）前辅助大隐静脉（AAGSV）与大隐静脉（GSV）在隐股交界处（SFJ）直接融合，术前超声未显示（1.7%）；RFA 后 GSV 残端长（7.8%）；小隐静脉（SSV）静脉曲张进展并伴有隐股交界处（SPJ）功能不全形成新的反流（4.7%）；d）胫腓侧穿静脉（Sherman，Boyd）和 Gunter 功能不全（3.8%）；e）在隐股交界处区域新生血管化伴小血管扩张（0.97%）。实施不同手术方法 3 年后，对生活质量（QL）进行了比较评估。因此，所有接受手术的患者的 QL 均显著优于手术前。然而，在 RFA GSV+AAGSV 后，与仅接受 RFA GSV 的患者相比，所有接受 RFA GSV+AAGSV 的患者的 QL 更好。同时进行 GSV 和 AAGSV 手术的患者的功能比仅进行 RFA GSV 的患者更好。
