Colli R, Modugno P, Revelli L, Alberti V, Flore R, Santoliquido A, Tondi P
Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, Roma.
Minerva Chir. 2005 Dec;60(6):481-6.
To compare the postoperative courses of patients subjected to closure procedure or stripping of the great saphenous vein (GSV).
We examined 2 groups of 15 patients with ostial and truncular saphenous insufficiency matched for CEAP clinical and anatomic classes. Group A patients underwent saphenous closure; short stripping was performed on those of Group B. In the Group A surgery was performed under spinal (12) or local (3) anesthesia; the procedure was preceded by crossotomy (5), crossectomy (1) or saphenous ligation (8); in 11 cases micro-phlebotomies were associated. In the Group B surgery was performed under general (5), spinal (7) or local (3) anesthesia; the procedure always was preceded by crossectomy (1); in 11 cases micro-phlebotomies were associated.
Group A patients were discharged 6-18 hours after surgery. None presented ecchymosis, hyperemia or skin lesions. Five complained of mild aching thigh pain, which did not require pain medication. All resumed normal daily activities the day after surgery and returned to work after 4.9 days. Six months after surgery, none of the patients had evidence of saphenous vein re-channeling. Group B patients were discharged 12-18 hours after surgery. Nine had ecchymosis on the thigh. Five reported mild thigh pain requiring analgesics. Normal daily activities and work were resumed 2.7 and 9.3 days after surgery.
This retrospective study seems to confirm that endoluminal radiofrequency ablation of the GSV provides good immediate results with no significant complications and can reduce postoperative pain and the length of convalescence with respect to those of stripping.
比较大隐静脉（GSV）闭合术或剥脱术患者的术后病程。
我们检查了两组各15例患有开口处和主干大隐静脉功能不全的患者，两组患者在CEAP临床和解剖学分级上相匹配。A组患者接受大隐静脉闭合术；B组患者进行短段剥脱术。A组手术在脊髓麻醉（12例）或局部麻醉（3例）下进行；手术前进行了交叉切开术（5例）、交叉切除术（1例）或大隐静脉结扎术（8例）；11例患者同时进行了微静脉切除术。B组手术在全身麻醉（5例）、脊髓麻醉（7例）或局部麻醉（3例）下进行；手术前总是进行交叉切除术（1例）；11例患者同时进行了微静脉切除术。
A组患者术后6 - 18小时出院。无人出现瘀斑、充血或皮肤损伤。5例患者抱怨大腿有轻微疼痛，无需止痛药物。所有患者术后第二天恢复正常日常活动，4.9天后恢复工作。术后6个月，所有患者均无大隐静脉再通迹象。B组患者术后12 - 18小时出院。9例患者大腿出现瘀斑。5例患者报告大腿轻度疼痛，需要使用止痛药物。术后2.7天和9.3天恢复正常日常活动和工作。
这项回顾性研究似乎证实，大隐静脉腔内射频消融术能提供良好的即时效果，无明显并发症，与剥脱术相比，可减轻术后疼痛并缩短康复时间。
