| 摘要 |
Objective: To retrospectively analyze the results of treatment on Taiwanese patients
with primary varicosities of the lower extremities including concomitant use of
endovenous laser, phlebectomy, and sclerotherapy.
Methods: We routinely used tumescent anesthesia and ultrasound-guided
approaches for the application of endovenous laser. Vein access was achieved by
either a percutaneous or stab wound. The laser power was usually 10 - 14 watts, laser
treatment usually was begun from 4 cm below the saphenofemoral junction, and
stopped around the knee, not over 10 cm below the knee. In the same operation, we
used Mueller s phlebectomy and/or sclerotherapy if there were prominent branch
varicosities. We instructed each patient to walk around immediately after the operation,
to go home, and to come back 1-3 days later for follow-up.
Results: One hundred and eighteen limbs in 102 patients were treated with the
ambulatory method from October 2003 to December 2004. Using ultrasoundguidance
and perivenous tumescent anesthesia, endovenous placement of laser fiber
was achieved in each case. The laser delivery rates we used were 43.68 27.28
joules/cm, with fluency of 18.47 13.48 joules/cm square. The mid-term results 12 to
24 months after surgery indicated a 96.61% success rate. There was no failure when
laser fired above 17.24 joules/cm or 5.49 joules/cm square. Thirty-two (32) limbs had
concomitant Mueller s ambulatory phlebectomies and 33 limbs sclerotherapies. All
patients could walk around immediately after the treatment. The 1st - 3rd postoperative
day pain score was 2.94 1.91, and no serious complications occurred.
Conclusions: With the use of ultrasound guidance and tumescent anesthesia,
endovenous laser treatment with concomitant phlebectomy and sclerotherapy for
primary varicosities of the lower extremities can be safely and effectively done on an
out-patient basis for Taiwanese patients. Neither bed-rest nor hospitalization is necessary. |
