Termal ablasyon, nontermal ablasyon ve cerrahi striping uygulamaları: 1 yıllık tek merkezde erken sonuçlar

Yıl 2022, Cilt: 13 Sayı: 47, 417 - 424, 15.12.2022

Metin Onur Beyaz , Senem Urfalı , Onur Koyuncu , İyad Fansa

https://doi.org/10.17944/mkutfd.1121446

Öz

Amaç: 1990’lı yıllardan başlayarak endovenöz lazer ablasyon (EVLA), radyofrekans ablasyon (RFA) ve ultrason eşliğinde köpük skleroterapi (UGFS) gibi minimal invaziv yöntemler geliştirildi.

Yöntem: Bu çalışma toplam 136 hastayı içermektedir (81 kadın/55 erkek) 22’ (10 kadın/12 erkek) klasik cerrahi stripping, 54’ (32 kadın/22 erkek) termal ablasyon ve 60’ (39 kadın/21 erkek) termal olmayan ablasyon ile tedavi edildi.

Bulgular: Yirmi iki hasta (10 kadın/12 erkek) cerrahi stripping ile tedavi edildi. Bir kadın hastada operasyon sonrasında kruris medialinde hematom meydana geldi. 54 hastada (32 kadın/22 erkek) termal ablasyon işlemlerinde radyofrekans kateter (ThermoBLOCK TM) kullanıldı. Bir kadın hastada işlem sonrası kalıcı parestezi gelişti. 3 erkek hastada ameliyat sonrası geçici parestezi gelişti. 60 hastaya (39 kadın/21 erkek) termal olmayan ablasyon uygulandı. 6 hastada (5 kadın/1 erkek) işlem sırasında şiddetli yanma olmasına rağmen bu semptom geçiciydi. Bir hastada postoperatif altıncı günde popliteal ven düzeyinde derin ven trombozu (DVT) gelişti.

Sonuç: Termal ve termal olmayan ablasyon ve cerrahi işlemler aynı ağrı azaltma oranlarına sahip olsa da cerrahi işlemlerde hematomlar ve hastanede daha uzun süre kalış daha sık görülür.

Anahtar Kelimeler

Kronik venöz yetmezlik, stripping, termal ablasyon, termal olmayan ablasyon

Thermal ablation, nonthermal ablation and surgical striping applications: 1-year single center early results

Öz

Objective: Starting from the 1990’s minimally invasive methods such as endovenous laser ablation (EVLA), radiofrequency ablation (RFA), and ultrasound-guided foam sclerotherapy (UGFS) developed.

Method: This study includes a total of 136 patients (81 women/55 men), of whom 22 (10 women/12 men) were treated with classic surgical stripping, 54 (32 women/22 men) with thermal ablation and 60 (39 women/21 men) with non-thermal ablation.

Results: Twenty-two patients (10 women/12 men) were treated with surgical stripping. In one female patient a hematoma arose in the medial crural region postoperatively. A radiofrequency catheter (ThermoBLOCK TM) was used in the thermal ablation procedures in 54 patients (32 female/22 male). While permanent paresthesia occurred in one female patient after the procedure, temporary paresthesia occurred in 3 male patients postoperatively. Non-thermal ablation was performed in 60 patients (39 female/21 male). Even through a severe burning sensation was present in 6 patients (5 female/1 male) during the procedure, this symptom was only transient. In one of the patients, deep venous thrombosis (DVT) occurred at the level of the popliteal vein postoperatively at the sixth day.

Conclusion: Even if thermal and non-thermal ablation and surgical procedures have the same pain decreasing rates, hematomas and a longer hospital stay are more frequent in surgical procedures.

Anahtar Kelimeler

stripping, thermal ablation, non-thermal ablation, Venous Insufficiency

Kaynakça

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