Olivier C
J Chir (Paris). 1975 May-Jun;109(5-6):565-74.
Among our cases of post-operative recurrent varicose veins, we report here only those cases which required further surgery. Thus we were able to carry out a comparative study of a series of 30 patients who were re-operated on between the 16th of March 1959 and the 16th of March 1966, and 44 patients operated on under the same conditions between the 16th of March 1966 and the 16th of March 1974. The causes of recurrence were different in the two groups. Before 1966, they were mainly due to the choice of inefficacious operations. Since 1966, they are due to poor technique in resection of the junction of the femoral vein with the saphenous vein. This was the most common cause, and these failures were favoured by saphenous abnormalities. Associated with stripping of the large vessels, resection of inguinal cavernoma which prolonged the femoro-saphenous junction, was the main stage in these re-operations. It was perfectly efficacious in the treatment of varicose veins but required also resection of inguinal lymph nodes with the cavernoma. Post-operative complications, such as lymphatic fistula and oedema, led us to prefer simple isolation of the cavernoma from the deep veins, but the first and essential stage remains resection of the junction of the femoral and saphenous veins and stripping of accessory trunks.
在我们的术后复发性静脉曲张病例中，这里仅报告那些需要进一步手术的病例。因此，我们能够对1959年3月16日至1966年3月16日期间再次接受手术的30例患者，以及1966年3月16日至1974年3月16日期间在相同条件下接受手术的44例患者进行了一项对比研究。两组复发的原因不同。1966年以前，复发主要是由于选择了无效的手术方式。自1966年以来，复发是由于股静脉与大隐静脉交界处切除技术不佳。这是最常见的原因，而大隐静脉异常会促使这些手术失败。与大血管剥脱术相关，切除延长了股隐静脉交界处的腹股沟海绵状瘤，是这些再次手术的主要步骤。它在治疗静脉曲张方面非常有效，但也需要连同海绵状瘤一起切除腹股沟淋巴结。术后并发症，如淋巴瘘和水肿，使我们更倾向于将海绵状瘤与深静脉简单分离，但首要且关键的步骤仍然是切除股静脉与大隐静脉的交界处以及剥脱附属主干。
