Varicose vein surgery stripping method compared to radio frequency ablation

Abstract

Background: This randomised study was conducted to evaluate clinical, patient based outcomes after RFA and conventional surgery in a selected population. Methods: This study was conducted in the Meenakshi Medical College Hospital and Research Institute, Enathur, Kanchipuram, Tamil Nadu, India. Results: In present study, it was reported that 150 patients in total were assessed in the study, out of which, 110 were randomised, 100 underwent the intervention as a daily procedure. 50 patients underwent RFA and 50 patients had conventional surgery. In group R, males were 15, females were 35; in group C, males were 17 and females were 33. In CEAP classification, in C2 class, there were 40 in group R, 39 in group C; in C3 class, there were 8 in group R, 6 in group C; in C4-6 class, 2 were in group R and 5 were in group C. The highest total clinical severity score was 1 i.e. 30 in group R and 32 in group C. Highest venous disability score was in 1 i.e. 46 in group R, 42 in group C. Main outcomes after RFA and conventional surgery for great saphenous varicose veins. Theatre time was 80 mins in group R, 52 mins in group C, procedure time was 74 mins in group R, 46 mins in group C, pain in first week (VAS score) was 1.5 in group R, 3.5 in group C, duration of analgesia was 3 days in group R, 11 days in group C, in 4 days group R patients returned to normal activity, in 13 days group C patients returned to normal activity. Numbness/reduced sensation was followed up after 1 week and 6 week, in group R, 8 patients and in group C, 16 patients have shown numbness/reduced sensation after 1 week; 6 patients in group R and 14 patients in group C have shown numbness/reduced sensation after 6 weeks. Conclusions: This study concluded that compared to conventional surgery, RFA took longer time to perform but it gave better and significantly early outcome in patients with varicose veins.

Effect of saphenous vein space packing in conventional varicose vein surgery

“…Pseudothrombophlebitis was also seen more in the conventional method (26.7%) than saphenous vein space packing technique (10%). In the study findings of our study were found to be similar to the findings of by Figueiredo et al and Potula et al 8,12 Our main objective was to study the effect of packing on post-operative pain as pain in the most undesirable experience a patient may have immediately postprocedure. The pain was assed using VAS scale on postoperative day 2, day 4, day 7 and day 30 post-operative day.…”

“…In our study which is similar to the study done by Potula who showed an average operating time of 52 mins. 8 In our study the side of limb affected was almost equal with 31 (51.6%) on left side and 29 (48.4%) on right side in comparison to a study performed by Dur, Mackaay et al where the Right limb was involved in 48.55% and left limb in 51.45% of the subjects under study. 9 The most common presenting symptoms were dilated veins seen in about 90% of the subjects which was comparable to a study findings of Campbell et al Pain as a symptom was seen in only 23% of the subjects in our study as compared 23% in the study performed by W. B Campbell et al The most common complications seen among the study subjects was prominent veins 54 (90%) followed by pigmentation 30 (50%).…”

“…The complication seen in our study was also seen in other studies. 8,9,11 The post-operative complications were studied between the conventional group and the saphenous vein space packing group and it was noted that wound Infection was seen in only 4 (13.3%) in conventional group and 3 (10%) cases in saphenous vein space packing technique. Bleeding was seen more in the conventional method (53.3%) of varicose vein surgery than saphenous vein space packing technique (33.3%).…”