Sonnenberg S, Gowland-Hopkins N F
Queen Alexandra Hospital, Portsmouth Hospitals Trust, Southwick Hill Rd, Cosham, Portsmouth PO6 3LY, UK.
Phlebology. 2010 Oct;25(5):252-6. doi: 10.1258/phleb.2009.009054.
Short saphenous vein (SSV) surgery carries a high risk of failure to identify the saphenopopliteal junction (SPJ). We assessed the impact of surgical expertise on anatomical outcome from SSV surgery and the role of preoperative duplex SPJ marking in improving outcome for vascular and non-vascular specialists.
A retrospective analysis identified patients (30 limbs) who had undergone SSV surgery. These were recalled for duplex scanning of the SPJ. In a prospective study, 187 limbs had preoperative duplex marking of SPJ and postoperative duplex to assess outcome. Grade of operating surgeon was recorded in both retrospective and prospective analysis.
In both retrospective and prospective analysis, vascular specialists were significantly more likely than non-vascular specialists to correctly identify the SPJ (P < 0.0001). Preoperative SPJ marking did not improve outcome for the vascular specialist or the non-vascular specialist.
Preoperative SPJ marking is no substitute for surgical expertise. Competence in SSV surgery should be assessed prior to surgeons proceeding to independent practice.
小隐静脉（SSV）手术存在较高的未能识别隐股腘静脉交界处（SPJ）的风险。我们评估了手术专业技能对SSV手术解剖学结果的影响，以及术前双功超声标记SPJ在改善血管专科医生和非血管专科医生手术结果方面的作用。
一项回顾性分析确定了接受SSV手术的患者（30条肢体）。对这些患者进行了SPJ的双功超声扫描复查。在一项前瞻性研究中，187条肢体进行了术前SPJ双功超声标记及术后双功超声检查以评估手术结果。在回顾性和前瞻性分析中均记录了手术医生的级别。
在回顾性和前瞻性分析中，血管专科医生比非血管专科医生更有可能正确识别SPJ（P < 0.0001）。术前SPJ标记并未改善血管专科医生或非血管专科医生的手术结果。
术前SPJ标记不能替代手术专业技能。在外科医生开始独立执业之前，应评估其进行SSV手术的能力。
