Division of Cardiovascular Surgery, Venous Centre, University Hospital of Geneva and Faculty of Medicine, University of Geneva, 4 rue Gabrielle-Perret-Gentil, CH 1211 Geneva, Switzerland.
Eur J Vasc Endovasc Surg. 2012 Jan;43(1):95-9. doi: 10.1016/j.ejvs.2011.09.022. Epub 2011 Oct 19.
Surgery for varicose veins is still the method of choice worldwide. When varicose veins require bilateral surgery, a single procedure often is the preferred choice by the patient. Today, unilateral varicose vein surgery is frequently performed as an outpatient procedure, while in many institutions bilateral surgery is done as an in-hospital procedure.
Retrospective comparative study.
Between 1 October 2004 and 31 October 2006, 433 patients underwent surgery for the great saphenous vein as in-patient procedure (303 unilateral and 130 bilateral), period 1. From 1 November 2006 until 31 December 2009, 825 patients had ambulatory great saphenous vein surgery (550 unilateral and 275 bilateral), period 2. We have compared unilateral and bilateral varicose vein surgery (high ligation and stripping of the great saphenous vein) and in-hospital procedures with ambulatory surgery, with regard to postoperative complications, postoperative pain and midterm follow-up.
Operation time and total length of stay in the institution following varicose vein surgery were significantly shorter for period 2 compared with period 1 for both unilateral and bilateral surgery, without other differences between the groups. There were few postoperative complications without differences between periods, and between unilateral and bilateral surgery (wound infection 0.5%, haematoma requiring drainage 0.2%, transient paraesthesia 1.1%, superficial localised thrombophlebitis 0.6% and deep vein thrombosis in one unilaterally operated case only).
Bilateral varicose vein surgery can be safely performed as an outpatient procedure, without increased risk of postoperative complications, increased postoperative discomfort or midterm adverse effects compared with unilateral surgery.
静脉曲张手术仍然是全世界的首选方法。当静脉曲张需要双侧手术时，患者通常首选单次手术。如今，单侧静脉曲张手术通常作为门诊手术进行，而在许多机构中，双侧手术则作为住院手术进行。
回顾性比较研究。
2004 年 10 月 1 日至 2006 年 10 月 31 日期间，433 例患者接受大隐静脉住院手术治疗（303 例单侧，130 例双侧），为第 1 期。从 2006 年 11 月 1 日至 2009 年 12 月 31 日，825 例患者接受门诊大隐静脉手术（550 例单侧，275 例双侧），为第 2 期。我们比较了单侧和双侧静脉曲张手术（大隐静脉高位结扎和剥脱术）以及住院手术与门诊手术，比较了术后并发症、术后疼痛和中期随访。
第 2 期单侧和双侧静脉曲张手术的手术时间和住院总时间明显短于第 1 期，而各组之间没有其他差异。术后并发症发生率低，无明显差异，且在各期之间、单侧和双侧手术之间无差异（感染 0.5%，血肿需引流 0.2%，短暂性感觉异常 1.1%，浅表局部血栓性静脉炎 0.6%，仅 1 例单侧手术发生深静脉血栓）。
与单侧手术相比，双侧静脉曲张手术可以安全地作为门诊手术进行，不会增加术后并发症、术后不适或中期不良后果的风险。
