Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Endovenous Laser Treatment (EVLT) with High Ligation of an Incompetent Small Saphenous Vein

소복재정맥 역류에서 고위결찰술을 동반한 정맥내 레이저 치료

  • Jeong, Jae-Han (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University) ;
  • Kim, Kun-Il (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University) ;
  • Lee, Won-Yong (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University) ;
  • Kim, Hyoung-Soo (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University) ;
  • Cho, Sung-Woo (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University) ;
  • Lee, Hee-Sung (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University)
  • 정재한 (한림대학교 의과대학 흉부외과학교실) ;
  • 김건일 (한림대학교 의과대학 흉부외과학교실) ;
  • 이원용 (한림대학교 의과대학 흉부외과학교실) ;
  • 김형수 (한림대학교 의과대학 흉부외과학교실) ;
  • 조성우 (한림대학교 의과대학 흉부외과학교실) ;
  • 이희성 (한림대학교 의과대학 흉부외과학교실)
  • Received : 2009.11.05
  • Accepted : 2009.11.12
  • Published : 2010.04.05
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Abstract

Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.

배경: 최근 하지 정맥류 치료에 정맥 내 레이저 치료가 도입되어 비침습적이면서도 좋은 치료 결과들이 많이 보고되고 있다. 저자들은 소복재정맥 역류로 인한 하지정맥류 환자를 대상으로 고위결찰술과 함께 정맥내 레이저치료를 동시에 시행하였고 그 효용성과 안전성을 알아 보고자 하였다. 대상 및 방법: 2006년 1월부터 2009년 5월까지 소복재정맥 역류에 의한 하지 정맥류 치료에 고위결찰술과 함께 정맥내 레이저치료를 받은 환자 60명(66예)을 대상으로 하였다. 수술 전 임상 양상과 수술 결과, 그리고 수술 후 1개월과 3개월의 추적 초음파 검사 결과를 분석하였다. 결과: 수술 관련 합병증은 17명(25예, 28.3%)에서 발생하였고 수술 후 감각 이상은 5예(7.6%)였고 심부정맥혈전증은 없었다. 3개월까지 추적 초음파 검사가 가능한 경우는 93.9% (62/66)였고 정맥완전폐쇄율은 1개월, 3개월에 각각 91.9% (57/62), 90.3% (56/62)였다. 결론: 저자들은 소복재정맥 역류 환자에서 고위결찰술을 동반한 레이저 치료와 보행성 정맥절제술을 시행하여 비교적 만족할 만한 합병증의 수술 결과를 보였으나 고위결찰술을 병행했음에도 완전정맥폐쇄율은 다소 낮았다. 소복재정맥 레이저 치료시 신경손상합병증을 배제할 수 있으면서도 정맥폐쇄율을 향상시키기 위한 추가 연구 노력이 필요하다.

Keywords

References

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