Klitfod Lotte, Baekgaard Niels
Karkirurgisk Afdeling B, Amtssygehuset i Gentofte, DK-2900 Hellerup.
Ugeskr Laeger. 2003 Jul 28;165(31):3013-5.
The recurrence rate for varicosities is up to 40%, which leads to reoperation for many patients. The purpose of this study was to evaluate the results after stripping the long saphenous vein in addition to the reoperation in the groin. The study was designed as a retrospective follow-up study and was set at the department of vascular surgery, Amtssygehuset i Gentofte.
The operations were performed from January 1st to the end of December 2000 and consisted of reoperation in the groin and stripping of the long saphenous vein from groin to knee in 39 patients with 44 legs which had been operated. No patients had had their saphenous vein stripped earlier. The follow-up consisted of duplex scanning and the mean follow-up time was 18 months.
Thirty legs (68%) were cured, twelve (27%) had reflux in the thigh--eight from a Hunterperforant and four in a long saphenous vein duplication. Two (5%) had remaining reflux in the groin.
The recurrence rate in the groin (5%) is acceptable. Stripping of the long saphenous vein in addition to reoperation in the groin reduces the recurrence rate. The recurrence rate at the thigh is not acceptable and a possible explanation for this is the potential role of some kind of long saphenous vein duplications. Half of the patients with recurrence are offered a new operation. We believe that the operating surgeon should focus more on duplication of the vein at the pre-operative duplex scanning in order to reduce the recurrence rate further. New varicosities can arise from an insufficient Hunterperforant even when the whole superficial system is stripped.
静脉曲张的复发率高达40%，这导致许多患者需要再次手术。本研究的目的是评估除腹股沟再次手术外，大隐静脉剥脱术后的效果。本研究设计为一项回顾性随访研究，研究地点设在根措夫特医院血管外科。
手术于2000年1月1日至12月底进行，包括对39例患者的44条已接受手术的腿进行腹股沟再次手术及从腹股沟至膝部的大隐静脉剥脱术。此前没有患者进行过大隐静脉剥脱术。随访包括双功超声扫描，平均随访时间为18个月。
30条腿（68%）治愈，12条腿（27%）大腿有反流——8条来自亨特穿通静脉，4条在大隐静脉重复处。2条腿（5%）腹股沟仍有反流。
腹股沟的复发率（5%）是可以接受的。除腹股沟再次手术外，大隐静脉剥脱术可降低复发率。大腿的复发率不可接受，对此可能的解释是某种大隐静脉重复的潜在作用。一半复发患者接受了再次手术。我们认为，手术医生在术前双功超声扫描时应更多地关注静脉重复情况，以进一步降低复发率。即使整个浅静脉系统都被剥脱，亨特穿通静脉功能不全也可能导致新的静脉曲张出现。
