Cic edizioni internazionali
Il Giornale di Chirurgia

Thermal ablation combined with high ligation of sapheno-femoral junction for lower limb primary varicosity

Original Article, 413 - 416
Tag this article
Full text PDF
Aim. For long time the traditional surgical treatment for lower limb varicose veins has been high ligation of sapheno-femoral junction and stripping of great saphenous vein. Surgery, however, has been frustrated by postoperative pains, discomfort and recurrences so that it has been challenged by minimally invasive endovenous techniques such as laser treatment and radiofrequency ablation. The aim of the article is to assess the feasibility of a combined approach to greater saphenous vein reflux: high ligation of sapheno-femoral junction and thermal treatment of the great saphenous vein.
Methods. A retrospective analysis on 95 patients treated with high ligation and thermal ablation at our institution was performed, assessing duration of surgery, post-operative pain and analgesics requirements, early complications and resumption of activities.
Results. Two patients (5,4%), in the laser group experienced skin burns in the course of the GSV. Moderate ecchymosis, by laser fibre-Romainduced perforation of the vein wall, were observed in another two patients (5.4%). Four limbs (10.8%) in the EVLT group developed transient paraesthesias.
Analgesic requirement on POD 3 was nil for RFA group; conversely half of the EVLT patients did take analgesics, either 2 or 3 tabs were required. On POD 7, the patients of RFA group continued to not ask for any analgesics, but the same half of the patients in EVLT group still needed 1-2 tabs to carry out their normal activities smoothly. On POD 15, no patient did require analgesics.
Resumption of routine activities was earlier for RFA group patients than for those in the EVLT group. The RFA group resumed their activities within 3 days, whereas EVLT group in 8-9 days.
High ligation of the SFJ didn’t add too much time or morbidities.
Conclusion. High ligation of saphenous femoral arc combined with catheter delivered thermal energies for saphenous ablation, even when combined with high ligation of saphenous femoral arc, demonstrated to be minimally invasive, easy to learn and easy to perform, with early resumption and return to normal activity.
EVLT achieved similar results to RFA and both techniques were considered equally effective and safe; the results we obtained were not statistically significant but RFA showed less pain, ecchymosis and haematomas, as well as provided better short-term quality of life.

Vol. XLI (No. 1) 2020 January - February

  1. Laparoscopic Roux-en-Y gastric bypass in the treatment of obesity: evidence based update through randomized clinical trials and meta-analyses
    Morales-Maza J., Rodriguez-Quintero J.H., Sanchez-Morales G.E., Sanchez Garcia-Ramos E., Romero-Velez G., Aguilar-Frasco J.L., Pimienta-Ibarra A.S., Alvarez-Bautista F.E., Leon P., Hernandez-Acevedo J.D., Del Angel-Millan G., Sierra M.
  2. Retroperitoneal sarcomas: from diagnosis to treatment. Case series and review of the literature
    Mantas D., Garmpis N., Polychroni D., Garmpi A., Damaskos C., Liakea A., Sypsa G., Kouskos E.
  3. The discriminative properties of erythrocyte anisocytosis in patients with resectable malignant pancreatic masses compared with an age and gender matched control group
    Akturk O.M., Çakir M.
  4. Diagnostic and therapeutic role of laparoscopy in perforated peptic ulcer in the elderly patients
    Giordano A., Prosperi P., Alemanno G., Bergamini C., Bruscino A., Valeri A.
  5. The role of laparoscopic surgery in isolated adrenal metastasis: our personal experience
    Frattolillo G., Paradiso G., Scarano Catanzaro V., Giordano L., Avantifiori R., D'Ermo G., Letizia C., De Toma G.
  6. Advances in bioengineering of complex tissues: state of the art of mucosae decellularization protocols
    Rizzo M.I., Contardi C., Esposito M., Zama M.
  7. An analysis of missed cases with surgical emergencies admitted in non-surgical departments. Case series and а review of the literature
    Popivanov G., Cirocchi R., Popov G., Stefanovski P., Andonova R., Kjossev K., Tonchev P., Tabakov M., Penkov M., Ivanov P., Mutafchiyski V.
  8. The evolution of robotic arm-assisted arthroplasty in Greece
    Koutserimpas C., Dretakis K.
  9. Current role of open surgery in adrenal tumors
    Chiappini A., Frattolillo G., Paradiso G., De Gori A., Scarano Catanzaro V., Avantifiori R., Fiori E., De Toma G.
  10. Preoperative fasting - “nihil per os” a difficult myth to break down: a randomized controlled study
    Panebianco A., Laforgia R., Volpi A., Punzo C., Vacca G., Minafra M., Di Salvo M., Pezzolla A.
  11. Sentinel lymph node biopsy with intraoperative touch imprint cytology (TIC) in breast cancer: experience of a mild-volume center
    Marano A., Sodano B., Vitiello C., Martini A.M., Baldassarre F., Siciliano A., Iannaci G.
  12. Spontaneous transdiaphragmatic intercostal hernia: clinical considerations and management
    Lonardo M.T., Frezzotti F., Collalti M., Natili A., Metere A.
  13. Systemic immune response after open tension-free inguinal hernia repair under different anesthetic alternatives: a prospective comparative study
    Symeonidis D., Diamantis A., Baloyiannis I., Tzovaras G., Tepetes K.
  14. Minilaparotomic incision for haemorrhagic corpus luteum: a case report
    Leanza V., Mininni C., Di Grazia F.M., Genovese F., Carbonaro A., Leanza G., Palumbo M.
  15. Conservative management of streptococcal necrotizing periorbital fasciitis following primary VZV infection
    Kontou E., Bontzos G., Triantafyllou D., Garnavou-Xirou C., Ragkousis A., Xirou T.
  16. Relief of hemorrhoid symptoms: pilot study of a new topical ally
    Gaj F., Bianchi F.P., Passannanti D., Tedesco D.
  17. Topical use of tranexamic acid in primary total knee arthroplasty: a comparative study
    Besiris G.TH., Koutserimpas C., Karamitros A., Karaiskos I., Tsakalou D., Raptis K., Kourelis K., Paxinos O., Kotsirakis A., Vlasis K.
  18. Insights in clinical examination and diagnosis of Athletic Pubalgia
    Koutserimpas C., Ioannidis A., Konstantinidis M.K., Makris M.C., Antonakopoulos F., Mazarakis A., Papagelopoulos P.J., Vlasis K., Konstantinidis M.K.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Thermal ablation combined with high ligation of sapheno-femoral junction for lower limb primary varicosity
    Florio G., Carnì P., D'Amata G., Crovaro M., Musmeci L., Manzi L., Del Papa M.