A 5-year Evaluation of the Recurrence Rate Following Conventional Surgery and Ablation for Venous Insufficiency Revealed That Although Ablation Methods Were Employed, Conventional Surgery Was Not Abandoned

Abstract

Objectives: Although conventional surgery (CS) has been less frequently employed in the treatment of great saphenous vein (GSV) in recent years, our clinic has not entirely abandoned this method. The objective of this study was to evaluate the recurrence and symptoms of patients treated with CS and radiofrequency ablation (RFA) for venous insufficiency (VI) 5 years ago.

Methods: A retrospective review was conducted on the results of 233 patients who were treated for varicose veins in our clinic 5 years ago (all in the same year). Patients aged 20 years or older with clinical class C2 to C6 clinical, etiological, anatomical, pathophysiological and GSV diameter >5.5 mm, reflux degree of at least 0.5 s were treated with RFA or conventional stripping. A total of 121 patients were treated with CS and 112 patients were treated with RFA. The method to be applied to the patients was randomly assigned without prior planning. The quality of life and recurrence rate were evaluated using the venous clinical severity score before surgery and at 1-month and 5-year intervals following surgery.

Results: In 2017, 233 patients were treated with RFA and CS methods due to VI (n=112, n=121). Clinical follow-up and examinations were conducted at the 1^st week, 1^st month, and 5^th year after surgery. A comparison of the two groups revealed that RFA was non-inferior to CS in terms of clinical relapse after 5 years. However, in terms of recurrence, the situation was 16.36% (n=9) in CS and 46.80% (n=22) in RFA. Recurrence was found to be significantly associated with the operational technique (p<0.006). Furthermore, the recurrence rate was significantly higher among patients who underwent venous pouch excision simultaneously with the main procedure (90.84%, n=139) compared to those who did not (9.15%, n=14; p<0.05).

Conclusion: As long as the recurrence rate of the traditional surgical stripping method remains low in the treatment of VI, this method will continue to be valuable. Although ablation methods are effective in our clinic, we have not abandoned traditional surgery. Since traditional surgery greatly reduces the risk of reoperation after many years, it should be recommended as an alternative choice to patients who are indicated for the procedure.

Cite This Article: Gojayev F, Yiğit F, Polat A. A 5-year Evaluation of the Recurrence Rate Following Conventional Surgery and Ablation for Venous Insufficiency Revealed That Although Ablation Methods Were Employed, Conventional Surgery Was Not Abandoned. Koşuyolu Heart J 2024;27(2):82–88

The study was approved by the Bağcılar Training and Research Hospital Non-interventional Clinical Research Ethics Committee (no: 2023.03.07/017, date: 24/03/2023).

Externally peer-reviewed.

Concept – F.G.; Design – F.G.; Supervision – A.P.; Funding – F.G.; Materials – F.G.; Data collection and/or processing – F.G.; Data analysis and/or interpretation – F.Y.; Literature search – F.G.; Writing – F.G.; Critical review – A.P.

All authors declared no conflict of interest.

Not declared.

The authors declared that this study received no financial support.

We are grateful to all our secretarial colleagues and nurses at the study center, whose support is very important and whose names are unfortunately never included in such a publication. Secretary Ayshegül and Sercan were the members responsible for making patient records, Nurse Esra controlling the treatment sessions and preparing the patients. We appreciate the work of our colleagues and express our gratitude.