Whiteley M S, Lewis G, Holdstock J M, Smith C, Harrisone C S, McGuinness C L, Price B A
The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey, GU2 7RF, UK.
Surgeon. 2006 Dec;4(6):372-3, 375-7. doi: 10.1016/s1479-666x(06)80113-7.
Small saphenous vein (SSV) disconnection and removal are challenging and considered by some authors to have too high a morbidity and failure rate to justify their routine use. Our audited results are at variance with these views.
We describe a reliable, ultrasound guided, minimally invasive technique for ligation and stripping of the SSV with an incision usually <1 cm. From our total series, 50 random patients attended for ultrasound review. The sapheno-popliteal junction (SPJ), strip track and signs of recurrence were assessed and recorded.
Since 1999, 627 patients (679 limbs) have undergone surgery for ultrasound proven SSV reflux. Fifty-two limbs (50 patients) were ultrasound assessed post-operatively. Fifty-one had flush ligation of the SPJ with one showing a 'stump' <1 cm. All showed successful SSV removal. Three limbs had minor strip track revascularisation but none had obvious clinical recurrence. Of the whole series, 11/627 (1.8%) developed proven deep vein thrombosis (DVT). There were six superficial wound infections and one strip track abscess. Sural nerve neurapraxia occurred in 13/627 (2.1%); one showing no sign of recovery at four weeks post-operatively.
Ultrasound guided SSV is a safe, minimally invasive technique with high success and low recurrence and complication rates
小隐静脉（SSV）离断和切除具有挑战性，一些作者认为其发病率和失败率过高，不值得常规应用。我们的审核结果与这些观点不一致。
我们描述了一种可靠的、超声引导的微创技术，用于结扎和剥脱SSV，切口通常小于1厘米。在我们的整个系列中，随机选取50例患者进行超声复查。评估并记录隐腘静脉交界处（SPJ）、剥脱路径及复发迹象。
自1999年以来，627例患者（679条肢体）因超声证实的SSV反流接受了手术。术后对52条肢体（50例患者）进行了超声评估。51例患者的SPJ进行了平齐结扎，1例的“残端”小于1厘米。所有患者的SSV均成功切除。3条肢体出现轻微的剥脱路径再血管化，但均无明显临床复发。在整个系列中，11/627（1.8%）发生了经证实的深静脉血栓形成（DVT）。有6例浅表伤口感染和1例剥脱路径脓肿。13/627（2.1%）发生了腓肠神经失用；1例在术后四周无恢复迹象。
超声引导下的SSV手术是一种安全、微创的技术，成功率高，复发率和并发症发生率低。
