Holme J B, Skajaa K, Holme K
Surgical Department, Odder Hospital, Denmark.
Acta Chir Scand. 1990 Feb;156(2):145-8.
To find out whether the usual total stripping of the long saphenous vein in operations for varicose veins could be replaced by a less traumatic removal of only the femoral part of the vein, a randomised prospective study was carried out in 163 consecutive patients, of whom 157 were evaluable. Group A (n = 80) had total stripping and group B (n = 77) had partial stripping (extraction of the long saphenous vein from the groin to immediately below the knee). The two groups, which were comparable, were assessed three months after operation when 75 in group A (94%) and 75 in group B (97%) had excellent or good relief of symptoms and comparable absence of residual varicosities. Lesions of the saphenous nerve were found in 31 in group A (39%) and 5 in group B (7%) (p less than 0.001). There were few other complications. We conclude that preservation of the distal long saphenous vein not only reduces nerve damage, but also retains enough vein for use should coronary artery bypass or peripheral vascular grafting be necessary in future.
为了弄清楚在静脉曲张手术中,常规的大隐静脉完全剥脱术是否可以被创伤较小的仅去除静脉股部的手术所替代,对163例连续患者进行了一项随机前瞻性研究,其中157例可进行评估。A组(n = 80)接受完全剥脱术,B组(n = 77)接受部分剥脱术(从腹股沟至膝关节以下立即取出大隐静脉)。两组具有可比性,术后三个月进行评估,此时A组75例(94%)和B组75例(97%)症状得到极佳或良好缓解,且残余静脉曲张情况相当。A组31例(39%)发现隐神经损伤,B组5例(7%)(p小于0.001)。其他并发症很少。我们得出结论,保留大隐静脉远端不仅能减少神经损伤,而且在未来如果需要进行冠状动脉搭桥或外周血管移植时,还能保留足够的静脉以供使用。