Jaworucka-Kaczorowska Aleksandra, Oszkinis Grzegorz, Huber Juliusz, Wiertel-Krawczuk Agnieszka, Gabor Elżbieta, Kaczorowski Paweł
Second Department of Surgery, General and Vascular Surgery Clinic, University of Medical Sciences, Poznań, Poland Department of Pathophysiology of Locomotor Organs, University of Medical Sciences, Poznań, Poland.
Second Department of Surgery, General and Vascular Surgery Clinic, University of Medical Sciences, Poznań, Poland.
Phlebology. 2015 Apr;30(3):210-6. doi: 10.1177/0268355514539316. Epub 2014 Jun 6.
Saphenous nerve injury is the most common complication after surgical treatment of varicose veins. The aim of this study was to establish its frequency at great saphenous vein long stripping when four methods of surgery were applied.
Eighty patients were divided into four groups depending on different stripping methods. Sensory transmission in saphenous nerve and sensory perception of shank were examined before surgery and two weeks, three and six months afterwards with clinical neurophysiology methods.
In 36% of patients, surgeries caused the injury of saphenous nerve mainly by proximal stripping without invagination (65%, group I). Transmission disturbances ceased completely after three months in patients undergoing distal stripping with invagination (group IV), while in group I they persisted for six months in 35%. Group IV patients were the least injured and group I the most.
Neurophysiological findings may suggest that distal stripping with vein invagination gives the best saphenous nerve sparing.
隐神经损伤是静脉曲张手术治疗后最常见的并发症。本研究的目的是确定在应用四种手术方法进行大隐静脉长段剥脱时隐神经损伤的发生率。
80例患者根据不同的剥脱方法分为四组。术前以及术后两周、三个月和六个月，采用临床神经生理学方法检查隐神经的感觉传导及小腿的感觉。
36%的患者手术导致隐神经损伤，主要是由于近端非内翻剥脱（65%，I组）。接受远端内翻剥脱的患者（IV组）三个月后传导障碍完全消失，而I组35%的患者持续六个月。IV组患者损伤最轻，I组最重。
神经生理学结果可能提示，远端内翻静脉剥脱对隐神经的保护效果最佳。
