Clinical Efficacy Of Ultrasound-guided Central Venous Catheter Dilator In The Treatment Of Popliteal Cysts

Objective To compare the clinical efficacy of ultrasound-guided central venous catheter dilator and traditional open surgery in the treatment of popliteal cyst.Methods Sixty patients with popliteal cyst treated in First People’s Hospital of Jingzhou from December 2018 to June 2020 were selected and divided into ultrasound intervention group(group A)and traditional surgery group(group B).Preoperatively,the size of popliteal cyst was measured by ultrasound,the patients were evaluated using visual analogue scale(VAS)and Lysholm knee score,and popliteal cysts were assessed with Rauschning-Lindgren classification(RLC).In the group A(n=30),there were 17 cases of R-L grade II and 13 cases of R-L grade III.The valve communicating port between popliteal cyst and articular cavity of all patients was dilated using an ultrasound-guided central venous catheter dilator.In the group B(n=30),there were20 cases of R-L grade II and 10 cases of R-L grade III.The popliteal cyst was resected in all patients by traditional open approach.Baseline characteristics including age,gender,course of disease and cyst size,surgical duration,incision length,intraoperative blood loss and hospitalization time were compared between the two groups.All the patients were followed up for half a year.Cyst size,VAS score and Lysholm knee score were further counted before and after treatment.The R-L grade of popliteal cysts and improvement rate of grade 0～I before and after treatment were statistically analyzed.The intraoperative and postoperative complications and adverse reactions were recorded.Results No statistical differences were found in age,gender,course of disease,cyst size,VAS score and Lysholm knee score between the two groups.The surgical duration,incision length,blood loss and hospitalization time were(20.90±4.11)min,(2.12±0.28)mm,5(3,6)ml and(5.53±1.36)days in the group A,and(61.80±7.45)min,(92.93±16.95)mm,65(50,80)ml and(10.13±1.74)days in the group B,respectively,showing a statistical difference(P<0.05).Before treatment,cyst size was 6.04(5.67,6.83)cm~3and 6.56(5.64,8.07)cm~3 in the group A and B,respectively.After treatment,cyst size was 2.23(2.01,3.10)cm~3and 1.57(0.58,4.55)cm~3 in the group A and B,respectively.Cyst size presented significant differences in the two group before and after treatment(P<0.05).However,no significant difference was detected in cyst size between the two groups after treatment(P>0.05).Preoperative VAS score was 3.00(3.00,4.25)and 3.50(3.00,4.00),and postoperative VAS score was 1.00(1.00,2.00)and 2.00(1.75,2.00)in the group A and B,respectively,showing significant differences in the two groups before and after treatment(P<0.05),but no significant difference between the two groups after treatment(P>0.05).Lysholm knee score was(43.50±7.72)and(42.83±5.13)before surgery,and(70.13±9.17)and(66.53±7.57)after surgery in the group A and B,respectively,presenting significant differences before and after treatment in the two groups(P<0.05),but no significant difference between the two groups after treatment(P>0.05).Postoperative 6-month follow-up demonstrated that there were 7 cases of R-L grade 0,12 cases of R-L grade I,11 cases of R-L grade II and 0 case of R-L grade III in the group A,with the improvement rate of R-L grade 0-I of 63.3%,and 5 cases of R-L grade 0,13 cases of R-L grade I,11cases of R-L grade II and 1 case of R-L grade III in the group B,with the improvement rate of R-L grade 0-I of 60%.No statistically significant difference was found in R-L classification between the two groups(P>0.05).In the group A,one patient had a soybean grain-sized scar at the puncture point due to scar constitution,and no complications.In the group B,one patient reported that the pain was aggravated and the movement of the knee joint was partially limited.Conclusion Compared with traditional surgery,ultrasound-guided central venous catheter dilator has incomparable advantages in surgical duration,incision length,intraoperative blood loss and hospitalization time in the treatment of popliteal cyst.There are no significant differences in VAS score,Lysholm score or R-L grade improvement rate between the two groups after surgery,but they are significantly improved compared with those before surgery.It indicates that treating popliteal cysts with ultrasound-guided central venous catheter dilator not only is less invasive,easy to operate,short hospital stay and rapid recovery,but also can achieve the same curative effect as traditional surgery and is more easily accepted by patients,providing a new idea and effective treatment method for the clinical treatment of popliteal cysts.