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使用球囊剥离器的筋膜下内镜交通静脉手术及大隐静脉手术治疗慢性静脉功能不全

Subfascial endoscopic perforator vein surgery using balloon dissector and saphenous vein surgery in chronic venous insufficiency.

作者信息

Uncu H

机构信息

Department of Surgery, Ankara Güven Hospital, Ankara, Turkey.

出版信息

Phlebology. 2007;22(3):131-6. doi: 10.1258/026835507780807220.

Abstract

OBJECTIVES

Subfascial endoscopic perforator vein surgery (SEPS) has recently been a popular alternative to classical surgical methods in the treatment of severe venous insufficiency of the lower extremity. Yet, there are not many reports concerning this less invasive operation, and many modified methods are applied. We would like to report the clinical results of our country's first SEPS operations performed by using balloon dissector.

METHODS

The SEPS via two ports and using balloon dissector with saphenous vein stripping and phlebectomy in patients with severe venous insufficiency. Pneumatic tourniquet has never been applied.

RESULTS

Twenty-eight operations were performed on 28 patients (13 female, 15 male). Active open ulcers were present in four legs, ulcer scars were present in two patients, skin changes were present in 12 legs and severe oedema was present in 10 legs. An improvement in all clinical findings and complaints was determined following the operations. A significant drop was determined in chronic venous insufficiency scores. No serious complication requiring rehospitalization of the patients was observed. All the patients were followed up for six months, and none presented again with any complaints.

CONCLUSION

SEPS using balloon dissector with saphenous vein surgery we performed is an effective, reliable and promising method.

摘要

目的

近年来,筋膜下内镜交通静脉离断术(SEPS)已成为治疗严重下肢静脉功能不全的经典手术方法的一种流行替代方法。然而,关于这种微创手术的报道并不多,且应用了许多改良方法。我们想报告我国首例使用球囊剥离器进行SEPS手术的临床结果。

方法

对严重静脉功能不全患者采用双端口SEPS并使用球囊剥离器,同时进行大隐静脉剥脱和静脉切除术。从未使用过气动止血带。

结果

对28例患者(13例女性,15例男性)进行了28次手术。4条腿有活动性开放性溃疡,2例有溃疡瘢痕,12条腿有皮肤改变,10条腿有严重水肿。术后所有临床症状和体征均有改善。慢性静脉功能不全评分显著下降。未观察到需要患者再次住院的严重并发症。所有患者均随访6个月,无一例再次出现任何症状。

结论

我们采用球囊剥离器结合大隐静脉手术进行的SEPS是一种有效、可靠且有前景的方法。

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