Kam M H, Tan S G
Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2003 Dec;44(12):639-42.
To audit retrospectively all long saphenous vein stripping performed or supervised intra-operatively by a single surgeon over a seven-year period.
One hundred and twenty-four patients (156 limbs) operated primarily in standard surgeon-supervised operations, were audited.
All patients were questioned via telephone interviews, and those with symptoms or recurrent varicosities were recalled for clinical review and investigations by the surgeon.
Eighty-seven cases presented with lower limb pain, 36 with eczema and 27 with ulcer. Eighty-one percent of operations were performed for symptomatic varicose veins and 19% were done for cosmesis. There were 153 limbs with varicosities, 121 of these had documented long saphenous vein reflux preoperatively. One hundred and sixteen limbs resolved post-operatively, five did not resolve, and four recurred. Incompetent perforators and short saphenous veins were the commonest causes of non-resolution and recurrence. Complications, including five cases of saphenous nerve paraesthesias, were temporary and met with full resolution eventually.
A 96% success rate is possible after high tie, stripping of the long saphenous vein with multiple avulsions of varicosities. Recurrence is 3% over the period of follow-up.
回顾性审核由一名外科医生在七年期间内主刀或术中指导下进行的所有大隐静脉剥脱术。
对124例患者（156条肢体）进行审核，这些患者主要接受标准的外科医生指导下的手术。
通过电话访谈对所有患者进行询问，有症状或静脉曲张复发的患者被召回，由外科医生进行临床检查和调查。
87例患者出现下肢疼痛，36例有湿疹，27例有溃疡。81%的手术是针对有症状的静脉曲张进行的，19%是为了美观。有153条肢体存在静脉曲张，其中121条术前记录有大隐静脉反流。116条肢体术后症状缓解，5条未缓解，4条复发。功能不全的交通静脉和小隐静脉是未缓解和复发的最常见原因。并发症包括5例隐神经感觉异常，均为暂时性，最终完全缓解。
高位结扎、大隐静脉剥脱并多处切除静脉曲张后成功率可达96%。随访期间复发率为3%。
