Labas P, Cambal M
First Department of Surgery, University Hospital Bratislava, Bratislava, Slovak Republic.
Int Angiol. 2009 Apr;28(2):147-50.
The aim of this study was to assess the results of a new type of antireflux operation on the deep venous system in patients with venous ulceration not responding to treatment of the superficial system and compression.
In the period comprised between 1991-2002, the authors treated 56 patients with venous ulceration by Fegan's technique, that consists in compression sclerotherapy combined with antireflux operation of the deep veins. All patients selected had pathological reflux in the deep venous system and their ulcers did not respond to superficial and perforating vein therapy, and elastic compression.
Using this technique of complex antireflux treatment, it was possible to heal 53 (95.4%) of the 56 ulcers with average time of complete ulcer epitelisation within 39+/-12 days. The recurrence rate, within the 5 year follow-up was 18% (10 patients), but 7 of the recurrent ulcers responded to compression sclerotherapy and healed within 3 months.
In situ made valvuloplasty has several advantages: the valve is constructed from autogenous vein wall; all luminal valve surfaces have native venous endothelium; intraluminal foreign material is not introduced; the likelihood of thrombosis is reduced; the valve is size-matched to the host vein and this technique provides a competent bicuspid valve.
本研究旨在评估一种新型抗反流手术对浅静脉系统治疗及压迫治疗无效的静脉性溃疡患者深静脉系统的治疗效果。
在1991年至2002年期间，作者采用费根技术治疗了56例静脉性溃疡患者，该技术包括压迫硬化疗法联合深静脉抗反流手术。所有入选患者深静脉系统均存在病理性反流，且其溃疡对浅静脉和穿通静脉治疗及弹性压迫均无反应。
采用这种综合抗反流治疗技术，56处溃疡中有53处（95.4%）愈合，溃疡完全上皮化的平均时间为39±12天。在5年随访期内，复发率为18%（10例患者），但其中7例复发性溃疡对压迫硬化疗法有反应，并在3个月内愈合。
原位瓣膜成形术有几个优点：瓣膜由自体静脉壁构建；所有管腔内瓣膜表面均有天然静脉内皮；不引入管腔内异物；降低血栓形成的可能性；瓣膜与宿主静脉尺寸匹配，且该技术可提供一个有效的二叶瓣。
