Comparison Transilluminated Powered Phlebectomy with the Conventional Surgical Treatment of Primary Varicose Vein of the Lower Limbs

Paik, Kwang Jai; Kim, Man Uoo; Kim, Ho Sung; Bae, Gook Hyun; Choi, Sang Yong; Park, Sin Hee; Lee, Kwang Chan; Kim, Chin Seung

Abstract

PURPOSE
This study was designed to compare Transilluminated Powered Phlebectomy (TIPP) with conventional surgical treatment (high ligation of the greater saphenous vein and above knee stripping with varicosectomy). METHODS: 428 cases of varicose veins, managed surgically at our hospital, were reviewed. A retrospective review of clinical records, between November 2000 an March 2003, was performed. The patients were divided into one of two groups: TIPP or a conventional operation. All the patients had at least a C2 CEAP disease. RESULTS: The demographics, hospital stays and operating times for the two groups were similar. However, a TIPP was associated with significantly fewer incisions (4.4+/-1.5 vs 8.2+/-3.9; P<0.001) and recurrence (n=14, 6% vs n=24, 12%; P=0.003). The incidence of a postoperative hematoma developing was more common with TIPP (n=20, 9% vs n=1, 0.5%; P=0.023). The problem of a hematoma formation in TIPP was solved by the insertion of a small closed suction drain. Skin perforation and wrinkling, and dermatosclerosis, were only complicated in the TIPP. The mean pain scores (out of 10) for the TIPP and conventional operation groups, at 2 and 7 days and 4 weeks, were 4.8, 1.4 and zero, and 4.8, 2.8 and zero, respectively. The cosmetic satisfaction score was higher in the TIPP group (8.7 vs 5.7; P<0.001). CONCLUSION: With respect to pain, cosmetic satisfaction and residual varicose, the outcomes in the TIPP group were significantly better than those in the conventional operation group.