Randomised Controlled Trial Comparing Sapheno-Femoral Ligation and Stripping of the Great Saphenous Vein with Endovenous Laser Ablation (980 nm) Using Local Tumescent Anaesthesia: One Year Results
Randomised Controlled Trial Comparing Sapheno-Femoral Ligation and Stripping of the Great Saphenous Vein with Endovenous Laser Ablation (980 nm) Using Local Tumescent Anaesthesia: One Year Results
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DOI：
10.1016/j.ejvs.2010.08.007
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发表时间：
2010-11-01
影响因子：
5.7
通讯作者：
van Vlijmen-van Keulen, C. J.
中科院分区：
文献类型：
--
作者：
Pronk, P.;Gauw, S. A.;van Vlijmen-van Keulen, C. J.
目的：使用局部肿胀麻醉，比较隐股静脉结扎剥脱术 (SFL/S) 与静脉内激光消融术 (EVLA，980 nm) 治疗大隐静脉 (GSV) 功能不全的情况。设计：随机、单中心试验。材料和方法：GSV 功能不全和静脉曲张的患者被随机分为两组 SFL/S 或 EVLA。在治疗后第 1、2、3、7、10 和 14 天，患者完成了有关疼痛和生活质量的调查问卷。通过在第 1 周、第 6 周以及第 6 个月和第 12 个月时进行的多普勒超声 (DUS) 评估复发性静脉曲张。结果：121 名患者的 130 条腿接受了 SFL/S (n = 68) 或 EVLA (n = 62) 治疗。与 EVLA 相比，EVLA 治疗后第 7、10 和 14 天的治疗后疼痛显着增加（p < 0.01；p < 0.01；p = 0.01），第 7 天（p < 0.01）和 10（p = 0.01）的活动障碍更多，第 7 天的自我护理（p = 0.03）和日常活动（p = 0.01）障碍更多SFL/S。 1 年随访 DUS 显示 EVLA 后复发率为 9%（5/56），SFL/S 后复发率为 10%（5/49）。 结论：SFL/S 和 EVLA 均采用局部肿胀麻醉，耐受性良好，短期复发率无差异。在 EVLA 后的第二周，与 SFL/S 相比，患者经历了明显更多的疼痛，导致活动能力、自我护理和日常活动受限。 (C) 2010 年欧洲血管外科学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Comparison of sapheno-femoral ligation and stripping (SFL/S) versus endovenous laser ablation (EVLA, 980-nm) in the treatment of great saphenous vein (GSV) insufficiency, using local tumescent anaesthesia.Design: Randomised, single centre trial.Materials and methods: Patients with GSV incompetence and varicose veins were randomised to either SFL/S or EVLA. At days 1, 2, 3, 7, 10, and 14 post-treatment, patients completed questionnaires on pain and quality of life. Recurrent varicose veins were evaluated by Duplex ultrasound (DUS) performed at 1 and 6 weeks, and 6 and 12 months.Results: 130 legs in 121 patients were treated by SFL/S (n = 68) or EVLA (n = 62). Significantly more post-treatment pain was noted after EVLA at days 7, 10 and 14 (p < 0.01; p < 0.01; p = 0.01), more hindrance in mobility at days 7 (p < 0.01) and 10 (p = 0.01), and in self care (p = 0.03) and daily activities (p = 0.01) at day 7 compared to SFL/S. DUS at 1-year follow-up showed 9% recurrences (5/56) after EVLA and 10% (5/49) after SFL/S.Conclusion: Both SFL/S and EVLA, using local tumescent anaesthesia, were well tolerated, with no difference in short-term recurrence rate. In the second week after EVLA, patients experienced significantly more pain resulting in restricted mobility, self care and daily activity compared to SFL/S. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.