[논문]복재정맥 부전에 대한 980-nm 다이오드 레이저를 이용한 치료와 전통적인 발거술 간의 비교: VCSS 점수와 재발에 의한 중기 임상 결과

최재성; 김응중; 이정상

doi:10.5090/kjtcs.2010.43.4.387

복재정맥 부전에 대한 980-nm 다이오드 레이저를 이용한 치료와 전통적인 발거술 간의 비교: VCSS 점수와 재발에 의한 중기 임상 결과
Comparison of Endovenous Treatment Using a 980 nm Diode Laser versus Conventional Stripping for Truncal Saphenous Vein Incompetence: Mid-term Results by VCSS Score and Recurrence 원문보기

大韓胸部外科學會誌 = The Korean journal of thoracic and cardiovascular surgery, v.43 no.4 = no.297, 2010년, pp.387 - 393

최재성 (동국대학교 의과대학 흉부외과학교실) , 김응중 (동국대학교 의과대학 흉부외과학교실) , 이정상 (서울대학교 보라매병원 흉부외과)

초록
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배경: 이번 연구의 목적은 정맥내 레이저 응고술(EVLT)과 발거술의 재발을 포함한 중기 임상 결과를 비교 평가하는 것이다. 대상 및 방법: 2007년 1월부터 2010년 2월까지 237명의 환자에서 대복재 및 소복재 정맥류 318개를 대상으로 980-nm 다이오드 레이저 또는 전통적인 발거술을 시행하였다. 첫 방문과 수술 후 1, 2, 6, 12, 18, 24, 36개월째 외래를 방문한 모든 환자를 대상으로 듀플렉스 초음파 검사와 Venous Clinical Severity Score (VCSS) 기록을 위한 임상검사 및 설문조사를 시행하였다. EVLT 및 정맥류 발거술의 두 치료군 간의 임상 결과를 비교하기 위해 수집된 모든 데이터를 이에 맞게 가공하여 분석하였다. 결과: 두 치료군 간에 관통정맥 부전의 수나 정맥 역류의 정도는 차이가 없었다. EVLT나 발거술로 대복재 및 소복재 정맥의 역류가 제거된 후 이 역류 제거 상태의 성공적인 유지율은 양 군간에 차이가 없었으며 12개월째 성공적인 유지율은 EVLT군이 $90.3{\pm}4.5%$, 발거술군이 $93.9{\pm}4.2%$였다. 전체적인 재발율은 EVLT군이 4.4%, 발거술군이 1.5%로 두 군간의 통계적인 차이는 없었다. VCSS 점수는 두 군 모두에서 수술 후 1주와 1개월, 2개월에 유의한 감소를 보였다. 결론: 대복재 및 소복재 정맥 부전의 제거에 대한 효율성이나 정맥 부전으로 인한 임상 경과의 수술 후 개선 능력 등에 있어 EVLT와 발거술은 비슷한 결과를 나타냈다.

Abstract ▼ AI-Helper

Background: The aims of the present study were to assess and compare mid-term clinical outcomes including recurrences between endovenous laser therapy (EVLT) and stripping. Material and Method: Between January 2007 and February 2010, 318 limbs in 237 patients with saphenous truncal varicosities were treated by laser energy using a 980 nm diode or were treated with conventional stripping. At the initial visit and at 1, 2, 6, 12, 18, 24, and 36 months postoperatively, clinical examination and questioning for Venous Clinical Severity Score (VCSS) as well as duplex ultrasonography were done. In order to compare clinical outcomes between the two treatment groups, EVLT versus stripping, all data were processed and analyzed. Result: There were no significant differences between the two treatment groups in the extent of the reflux and the number of insufficient perforating veins. The in EVLT and the stripping group at 12 months were $90.3{\pm}4.5%$ and $93.9{\pm}4.2%$, respectively (p>0.05). Total recurrence rates were 4.4% in the EVLT group and 1.5% in the stripping group (p>0.05). In both groups, the VCSS scores were significantly reduced at week 1, 1 month, and 2 months after EVLT or stripping (p<0.001). Conclusion: Efficiency in eliminating truncal saphenous vein incompetence and reducing venous clinical severity were equal in the two treatment groups.

주제어

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가설 설정

the aims of the present study wg to assess and compare (he mid-tertn clinical outcomes inchiding rtecurre/ices between EVLT and stripping.

제안 방법

18, 24, and 36 months postoperatively. At the initial visit to out-patient office, a clinical examination and questioning for VCSS record as well as duplex ultrasonogiaphy were performed, and the CEAP (Clioical severity, Etiology, Anatomy, Pathophysiology) stage was determined. At every follow-up visits, duplex ultrasound scanning and VCSS recording were performed.
At every follow-up visits, duplex ultrasound scanning and VCSS recording were performed. In order to compare the clinical outcomes between the two treatment groups, EVLT versus stripping, all data were processed and analyzed.
The patients attended follow-up at iweek and at 1, 2, 6, 12, 18, 24, and 36 months postoperatively. At the initial visit to out-patient office, a clinical examination and questioning for VCSS record as well as duplex ultrasonogiaphy were performed, and the CEAP (Clioical severity, Etiology, Anatomy, Pathophysiology) stage was determined.

데이터처리

0, SPSS Inc, Chicago, IL). Comparison between the two groups was performed using the impaired Student's t-test and chi-square test (Pearson chi-square and Fisher exact tests) for categorical variables. For the VCSS, intergroup comparisons were- made by Mann-Whitney U test and intra-group comparison by Friedman test.

성능/효과

The time to recurrence was analysed using log-rank, statistics. All results were expressed as the mean±standard deviation, and a p-val ue of less than 0.05 was considered statistieMly significant.
demonstrated that clinical severities of the disease were similarly reduced most markedly at 2 months after the operation and then start™ ed to rise again gradually in both treatments. This finding indicates that the two treatmBEts are equally efficient in elimi- Hathtruncal saphenous vein incompetency and improving venous sympts at least in a short -temi after operation. This early outcome and the general pattern of VCSS score are similar to other studies conipai'ing endovenous laser ablation and stripping[14, 20, 21], The results comparing endovenous laser ablation with stripping using VCSS to has been rarely reported.
were equal in both treatment groups. This study also showed that recurrent varicose veins were well treated and their progression were also well inteirupted by sclerotherapy.
This study showed the statistically significant improvement of the VCSS scores at 1 weak, 1 month, and 2 months pos- toperatively. The VCSS score plot in Fig.

참고문헌 (21)

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상세보기
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상세보기
Oh CK, Jung DS, Jang HS, Kwon KS. Endovenous laser surgery of the incompetent greater saphenous vein with a 980-nm diode laser. Dermatol Surg 2003;29:1135-40.

상세보기
Park SJ, Yim SB, Cha DW, Kim SC, Lee SH Endovenous laser treatment of the small saphenous vein with a 980-nm diode laser: early results. Dermatol Surg 2008;34:517-24.

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상세보기
Theivacumar NS, Darwood R, Gough MJ. Neovascularisation and recurrence 2 years after varicose vein treatment for saphenofemoral and great saphenous vein reflux: a comparison of surgery and endovenous laser ablation. Eur J Vasc Endovasc Surg 2009;38:203-7.

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상세보기
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상세보기
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상세보기
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상세보기
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