Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.20140060
Jornal Vascular Brasileiro
Artigo Original

Radiofrequency thermal ablation versus conventional saphenectomy

Ablação térmica por radiofrequência versus safenectomia convencional

Jeferson Freitas Toregeani; Antônio Severino Trigo Rocha; Claudio Jundi Kimura; Ricardo Adriano Gomes Araújo; Américo Kazuo Kawai; Larissa Sokol Rotta; Andressa Midori Fusioka

http://dx.doi.org/10.1590/1677-5449.20140060 J Vasc Bras, vol.14, n1, p.4-9, 2015
PDF English
PDF Português
Downloads: 1
Views: 1202

Abstract

BACKGROUND: Varicose veins of the lower limbs have a high prevalence worldwide. New treatment techniques have been developed with the objectives of improving patients' quality of life and reducing recovery times. OBJECTIVE: To evaluate patients with incompetent saphenous veins treated using conventional saphenectomy or radiofrequency ablation (RF), in terms of postoperative status. METHODS: From May 2012 to April 2013 146 varicose veins patients with saphenous insufficiency, 90 of whom were treated with conventional surgery (G1) and 56 with RF ablation (G2), were evaluated prospectively. RESULTS: In G1, 88.61% of patients complained of postoperative pain and needed to take analgesics, compared with 28.85% in G2 (p<0.05). Mean pain rating on an analog scale from 0 to 10 was 3.91±2.13 points for G1 and 1.76±3.01 points for G2 (p<0.05). Recovery periods ranged from 26.63±13.3 days to 18.26±19.37 days, for G1 and G2 respectively. Mean time taken to become totally asymptomatic was 66.78±60.9 days for G1 and 38.38±46.8 days for G2 (p<0.05). CONCLUSIONS: The RF treatment method caused less postoperative pain and resulted in earlier recovery, when compared to conventional saphenectomy.

Keywords

varicose veins, radiofrequency, saphenectomy

Resumo

CONTEXTO: As varizes dos membros inferiores têm elevada prevalência mundial e as técnicas convencionais de tratamento têm seus resultados bem definidos há décadas. O advento de novas tecnologias nos obriga a avaliar os resultados e compará-los com métodos tradicionais. OBJETIVO: Avaliar o tratamento de pacientes com varizes dos membros inferiores e insuficiência de safenas por safenectomia convencional (SF) ou ablação por radiofrequência (RF), quanto aos sintomas pós-operatórios. MATERIAIS E MÉTODOS: Entre maio/2011 e abril/2013, foram avaliados prospectivamente 146 pacientes com varizes dos membros inferiores e insuficiência de safenas, sendo 90 por SF (G1) e 56 por RF (G2). RESULTADOS: Quanto aos quesitos avaliados, o G1 evidenciou 88,61% dos pacientes com queixa de dor pós-operatória com necessidade do uso de analgésicos e o G2, 28,85% (p<0,05). A média da graduação da dor através da escala analógica - de 0 a 10 - foi de 3,91±2,13 pontos no G1 e de 1,76±3,01 pontos no G2 (p<0,05). O período de recuperação variou de 26,63±13,3 dias para o G1 e 18,26±19,37 dias para o G2. O tempo médio até tornar-se assintomático foi 66,78±60,9 dias para G1 e 38,38±46,8 dias para G2. CONCLUSÃO: A RF propiciou menor dor pós-operatória e recuperação mais precoce quando comparada à SF.

Palavras-chave

varizes, radiofrequência, safenectomia

Referências

Tisi P. Varicose veins. Clin Evid (Online).. :2007-007.

Brake M, Lim CS, Shepherd AC, Shalhoub J, Davies AH. Pathogenesis and etiology of recurrent varicose veins. J Vasc Surg.. ;57(3):860-68.

Seidel AC, Miranda F Jr, Juliano Y, Novo NF, dos Santos JH, de Souza DF. Prevalence of varicose veins and venous anatomy in patients without truncal saphenous reflux. Eur J Vasc Endovasc Surg.. ;28(4):387-90.

Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health.. ;53(3):149-53.

Figueiredo M, Araújo S, Barros N Jr, Miranda F Jr. Results of surgical treatment compared with ultrasound-guided foam sclerotherapy in patients with varicose veins: a prospective randomised study. Eur J Vasc Endovasc Surg.. ;38(6):758-63.

Gastos com cirurgia de varizes bilaterais. .

Puggioni A, Kalra M, Carmo M, Mozes G, Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg.. ;42(3):488-93.

Altin FH, Aydin S, Erkoc K, Gunes T, Eygi B, Kutas BH. Endovenous laser ablation for saphenous vein insufficiency: Short- and mid-term results of 230 procedures. Vascular. .

Burihan MC. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices. Sao Paulo Med J.. ;132(1):69-9.

van Eekeren RR, Boersma D, Konijn V, de Vries JP, Reijnen MM. Postoperative pain and early quality of life after radiofrequency ablation and mechanochemical endovenous ablation of incompetent great saphenous veins. J Vasc Surg.. ;57(2):445-50.

Devereux N, Recke AL, Westermann L, Recke A, Kahle B. Catheter-directed foam sclerotherapy of great saphenous veins in combination with pre-treatment reduction of the diameter employing the principals of perivenous tumescent local anesthesia. Eur J Vasc Endovasc Surg.. ;47(2):187-95.

Roth SM. Endovenous radiofrequency ablation of superficial and perforator veins. Surg Clin North Am.. ;87(5):1267-84, xii.

Winterborn RJ, Corbett CR. Treatment of varicose veins: the present and the future-a questionnaire survey. Ann R Coll Surg Engl.. ;90(7):561-64.

Guex JJ, Isaacs MN. Comparison of surgery and ultrasound guided sclerotherapy for treatment of saphenous varicose veins: must the criteria for assessment be the same?. Int Angiol.. ;19(4):299-302.

Virgini-Magalhães CE, Salvadori RAM, Fagundes FB. Cirurgia de varizes em regime de mutirão. J Vasc Bras.. ;6(3):231-37.

Seidel AC, Mangolim AS, Rossetti LP, Gomes JR, Miranda F Jr. Prevalência de insuficiência venosa superficial dos membros inferiores em pacientes obesos e não obesos. J Vasc Bras.. ;10(2):124-30.

Labropoulos N, Tiongson J, Pryor L. Definition of venous reflux in lower-extremity veins. J Vasc Surg.. ;38(4):793-98.

Engelhorn CA, Engelhorn AL, Cassou MF, Salles-Cunha SX. Patterns of saphenous reflux in women with primary varicose veins. J Vasc Surg.. ;41(4):645-51.

Toregeani JF, Michelan G, Fenato RR, et al. Diâmetro versus refluxo - análise de 2471 segmentos de veia safena interna. J Vasc Bras.. ;4(3, Supl. 1):S50-S50.

Rautio T, Ohinmaa A, Perälä J. Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. J Vasc Surg.. ;35(5):958-65.

Xenos ES, Bietz G, Minion DJ. Endoluminal thermal ablation versus stripping of the saphenous vein: Meta-analysis of recurrence of reflux. Int J Angiol.. ;18(2):75-8.

Subramonia S, Lees T. Sensory abnormalities and bruising after long saphenous vein stripping: impact on short-term quality of life. J Vasc Surg.. ;42(3):510-14.

Kumar RS, Gopinath M. A rare cause of foot drop after radiofrequency ablation for varicose veins: case report and review of the literature. Neurol India.. ;58(2):303-05.

Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg.. ;98(8):1079-087.

Lurie F, Creton D, Eklof B. Prospective randomized study of endovenous radiofrequency obliteration (closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study). J Vasc Surg.. ;38(2):207-14.

Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH. Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg.. ;97(6):810-18.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5de7fbe90e88252f34e31d42 jvb Articles
Links & Downloads
1677-7301 (Eletrônico)
J Vasc Bras ©2024 Todos os direitos reservados.

J Vasc Bras

Share this page
Page Sections