Lin Yun-Nan, Hsieh Tung-Ying, Huang Shu-Hung, Liu Chia-Ming, Chang Kao-Ping, Lin Sin-Daw
1 Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan.
Phlebology. 2018 Feb;33(1):44-52. doi: 10.1177/0268355516676124. Epub 2017 Jan 6.
Background Adequately excising varicose and incompetent perforating veins is necessary for reducing their recurrence rate of venous ulcer. Method In total, 66 venous ulcers (C6) in 1083 legs with primary varicose veins were managed through endoscopic-assisted surgery. In an endoscopic operative view, the nonvaricose, varicose, and incompetent perforating veins were clearly visualized and precisely dissected. The varicose and incompetent perforating veins were divided and completely excised. Result The varicose veins were traced to the base or periphery of the 55 ulcers. Moreover, 89.4% of the ulcers healed within 14 weeks. Kaplan-Meier analysis revealed a five-year recurrence rate of 0.0%, and the satisfaction mean score was 4.6. Conclusion Endoscopic-assisted surgery can be used to radically excise varicose veins complicated with venous ulcers; the surgery yields low recurrence and high satisfaction rates.
充分切除曲张和功能不全的穿支静脉对于降低静脉溃疡的复发率是必要的。方法：对1083条患有原发性静脉曲张的腿上的66处静脉溃疡（C6级）进行内镜辅助手术治疗。在内镜手术视野下，非曲张、曲张和功能不全的穿支静脉清晰可见并被精确解剖。曲张和功能不全的穿支静脉被分离并完全切除。结果：曲张静脉追踪至55处溃疡的底部或周边。此外，89.4%的溃疡在14周内愈合。Kaplan-Meier分析显示五年复发率为0.0%，满意度平均评分为4.6。结论：内镜辅助手术可用于根治合并静脉溃疡的曲张静脉；该手术复发率低，满意度高。
