Comparison of the Results of Radiofrequency Ablation and Phlebectomy of Suprafascial Segments of the Great Saphenous Vein in Patients With Varicose Disease of the Lower Extremities

Abstract

Summary. Introduction. Over the past two decades, such traditional surgical procedures as crossectomy and stripping have been replaced to a greater or lesser extent by less invasive endovenous methods. Unfortunately, endovenous ablation methods do not allow to completely exclude such complications as: hyperpigmentation, paresthesias, hematomas, thermal damage to the skin.
 Purpose.To improve the tactics and improve the cosmetic effect of surgical treatment of superficially located suprafascial segments of the great saphenous vein in patients with varicose veins of the lower extremities.
 Materials and methods. An analysis of the treatment of 107 patients with VDLE at the University Clinic of ZDMU in 2019-2021 was carried out. The first (main) group – 65 (60.75 %) patients – received surgical treatment according to the proposed method – RFA, miniphlebectomy of the suprafascially located main trunk, miniphlebectomy of the tributaries along the Varada. The second (comparison) group – 42 (39.25 %) patients – received standard treatment – RFA of the GSV trunk, miniphlebectomy.
 Research results. According to the control duplex scan in all patients, the deep vein passage was occluded in 106 (99.1 %) patients.
 The overall frequency of postoperative complications in the main group was 18.4 % (12 out of 65 patients), in the comparison group – 35.7 % (15 out of 42 patients, mainly due to hyperpigmentation) and was significantly different (р ˃ 0.05).
 According to the data of CIVIQ-2, the proposed method of surgical intervention made it possible to improve the quality of life from (31.72 ± 1.56) points in patients of the comparison group to (27.49 ± 1.45) in patients of the main group.
 Conclusions. The proposed tactic of surgical correction of the varicosity of the trunk of the GSV – RFA of the intrafascial area of the GSV plus miniphlebectomy of the suprafascial segment – allows to reduce the probability of the development of hyperpigmentation, which contributes to a better cosmetic effect, subjective satisfaction of patients with the results of the operation, and a better quality of life in patients with VDLE.