Kjeld Thomas, Baekgaard Niels
Amtssygehuset i Gentofte, Karkirurgisk Afdeling B.
Ugeskr Laeger. 2003 Jul 28;165(31):3009-13.
The article documents that among patients with saphenofemoral reflux inadequate surgery on the saphenofemoral junction was the cause of recurrence in 40% and 43% respectively of patients treated at hospitals and in out-clinics, but in only 14% when operation was performed by a specialized vascular surgeon. The causes of recurrence are described in the literature as follows: inadequate ligation, recanalisation, neovascularisation, non-saphenofemoral reflux, long saphenous vein duplication, incompetent perforator veins and inadequate stripping of the long saphenous vein. Our examination of the past ten years of literature in this area leads to the conclusion that patients with varicose veins caused by saphenofemoral reflux should be examined clinically as well as with colour-Doppler-ultrasonography. The main cause of recurrence is insufficient surgery. The surgeon may reduce recurrence rates by combining stripping of the long saphenous vein to the knee including duplications with thorough ligation of the saphenofemoral junction and ligation of adjacent side-branches. Stab avulsions are obligatory.
该文章记录了在患有大隐股静脉反流的患者中，大隐股静脉交界处手术不充分分别是医院和门诊所治疗患者复发的原因，比例分别为40%和43%，但由专业血管外科医生进行手术时，复发率仅为14%。文献中描述的复发原因如下：结扎不充分、再通、新生血管形成、非大隐股静脉反流、大隐静脉重复、穿支静脉功能不全以及大隐静脉剥脱不充分。我们对该领域过去十年文献的研究得出结论，由大隐股静脉反流引起的静脉曲张患者应进行临床检查以及彩色多普勒超声检查。复发的主要原因是手术不充分。外科医生可以通过将大隐静脉剥脱至膝部（包括重复静脉），同时彻底结扎大隐股静脉交界处和结扎相邻侧支来降低复发率。必须进行点状剥脱。
