Randomized clinical trial comparing multiple stab incision phlebectomy and transilluminated powered phlebectomy for varicose veins

Background: The aim was to compare early postoperative subjective outcome measures in a randomized trial of multiple stab incision phlebectomy (MSIP) and transilluminated powered phlebectomy (TIPP) for the treatment of varicose veins. Methods: Patients having surgery for varicose veins were randomiz...

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Veröffentlicht in:British journal of surgery 2006-02, Vol.93 (2), p.169-174
Hauptverfasser: Chetter, I. C., Mylankal, K. J., Hughes, H., Fitridge, R.
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container_title British journal of surgery
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creator Chetter, I. C.
Mylankal, K. J.
Hughes, H.
Fitridge, R.
description Background: The aim was to compare early postoperative subjective outcome measures in a randomized trial of multiple stab incision phlebectomy (MSIP) and transilluminated powered phlebectomy (TIPP) for the treatment of varicose veins. Methods: Patients having surgery for varicose veins were randomized to receive either MSIP or TIPP for local avulsion of varicose veins. Operating time, number of incisions and postoperative outcome were analysed in both groups. Quality of life (QoL) was analysed before and 1 and 6 weeks after surgery using domain‐specific (Burford pain scale), disease‐specific (Aberdeen Varicose Vein Questionnaire) and generic (Short Form 36 and EuroQol 5D) instruments. Results: Sixty‐six patients consented to participate in the trial but four withdrew before surgery, so 33 patients underwent MSIP and 29 patients had TIPP. All patients had symptomatic or complicated varicose veins. There was no significant difference between groups in the total duration of surgery or the time taken for the avulsions. The number of incisions was significantly lower with TIPP. However, skin bruising at 1 and 6 weeks, and Burford pain score at 6 weeks were significantly higher in the TIPP group (P < 0·01 for bruising and P = 0·019 for pain). TIPP also had a greater adverse impact on generic QoL, resulting in a more prolonged recovery. Conclusion: TIPP had the advantage of fewer surgical incisions, but was associated with more extensive bruising, prolonged pain and reduced early postoperative QoL. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. TIPP causes more extensive bruising
doi_str_mv 10.1002/bjs.5261
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Quality of life (QoL) was analysed before and 1 and 6 weeks after surgery using domain‐specific (Burford pain scale), disease‐specific (Aberdeen Varicose Vein Questionnaire) and generic (Short Form 36 and EuroQol 5D) instruments. Results: Sixty‐six patients consented to participate in the trial but four withdrew before surgery, so 33 patients underwent MSIP and 29 patients had TIPP. All patients had symptomatic or complicated varicose veins. There was no significant difference between groups in the total duration of surgery or the time taken for the avulsions. The number of incisions was significantly lower with TIPP. However, skin bruising at 1 and 6 weeks, and Burford pain score at 6 weeks were significantly higher in the TIPP group (P &lt; 0·01 for bruising and P = 0·019 for pain). TIPP also had a greater adverse impact on generic QoL, resulting in a more prolonged recovery. 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C.</creatorcontrib><creatorcontrib>Mylankal, K. J.</creatorcontrib><creatorcontrib>Hughes, H.</creatorcontrib><creatorcontrib>Fitridge, R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chetter, I. C.</au><au>Mylankal, K. J.</au><au>Hughes, H.</au><au>Fitridge, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized clinical trial comparing multiple stab incision phlebectomy and transilluminated powered phlebectomy for varicose veins</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2006-02</date><risdate>2006</risdate><volume>93</volume><issue>2</issue><spage>169</spage><epage>174</epage><pages>169-174</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background: The aim was to compare early postoperative subjective outcome measures in a randomized trial of multiple stab incision phlebectomy (MSIP) and transilluminated powered phlebectomy (TIPP) for the treatment of varicose veins. Methods: Patients having surgery for varicose veins were randomized to receive either MSIP or TIPP for local avulsion of varicose veins. Operating time, number of incisions and postoperative outcome were analysed in both groups. Quality of life (QoL) was analysed before and 1 and 6 weeks after surgery using domain‐specific (Burford pain scale), disease‐specific (Aberdeen Varicose Vein Questionnaire) and generic (Short Form 36 and EuroQol 5D) instruments. Results: Sixty‐six patients consented to participate in the trial but four withdrew before surgery, so 33 patients underwent MSIP and 29 patients had TIPP. All patients had symptomatic or complicated varicose veins. There was no significant difference between groups in the total duration of surgery or the time taken for the avulsions. The number of incisions was significantly lower with TIPP. However, skin bruising at 1 and 6 weeks, and Burford pain score at 6 weeks were significantly higher in the TIPP group (P &lt; 0·01 for bruising and P = 0·019 for pain). TIPP also had a greater adverse impact on generic QoL, resulting in a more prolonged recovery. 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source Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Adult
Aged
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
General aspects
Humans
Male
Medical sciences
Middle Aged
Quality of Life
Treatment Outcome
Varicose Veins - surgery
Vascular Surgical Procedures - methods
title Randomized clinical trial comparing multiple stab incision phlebectomy and transilluminated powered phlebectomy for varicose veins
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