Hong Ki Pyo
Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
J Chest Surg. 2023 Nov 5;56(6):387-393. doi: 10.5090/jcs.23.098. Epub 2023 Oct 11.
The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins.
This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery.
The study included 179 limbs from 120 patients (47 men and 73 women). The mean patient age was 56.5 years (range, 20-78 years), and the distribution of preoperative Clinical-Etiology-Anatomy-Pathophysiology clinical classes was 8% C0-C1, 88% C2, and 4% C3-C6. The preoperative diameter of the saphenofemoral confluence averaged 6.9 mm (range, 2.7-15.8 mm). After a mean postoperative follow-up period of 24 months, evidence of neovascularization around the stump of the saphenofemoral junction (SFJ) was observed in 2 limbs (1.1%). Additionally, varicose vein recurrence was found in 1 limb (0.6%) and was associated with an incompetent thigh perforator. At postoperative follow- up, both VCSS and AVVQ scores were significantly lower than the preoperative scores.
Modified surgical treatment of GSV incompetence, involving preservation of the SEV and stripping of a short segment up to the knee, demonstrated favorable clinical results in terms of postoperative complication rate, neovascularization rate around the SFJ stump, varicose vein recurrence rate, and improvement in lower extremity symptoms.
本研究的目的是评估一种改良手术方法治疗静脉曲张的临床疗效。
对2015年1月至2022年4月期间因症状性大隐静脉（GSV）功能不全而接受从腹股沟至膝部剥脱术并保留腹壁浅静脉（SEV）的下肢进行回顾性分析。术后6个月和12个月使用多普勒超声、静脉临床严重程度评分（VCSS）和阿伯丁静脉曲张问卷（AVVQ）进行随访评估。
该研究纳入了120例患者的179条肢体（47例男性和73例女性）。患者平均年龄为56.5岁（范围20 - 78岁），术前临床 - 病因 - 解剖 - 病理生理临床分级分布为8% C0 - C1、88% C2和4% C3 - C6。大隐静脉股静脉汇合处术前平均直径为6.9 mm（范围2.7 - 15.8 mm）。术后平均随访24个月后，在2条肢体（1.1%）中观察到股静脉交界处（SFJ）残端周围有新生血管形成的迹象。此外，在1条肢体（0.6%）中发现静脉曲张复发，且与大腿穿通支功能不全有关。术后随访时，VCSS和AVVQ评分均显著低于术前评分。
改良手术治疗GSV功能不全，包括保留SEV和剥脱至膝部的短段静脉，在术后并发症发生率、SFJ残端周围新生血管形成率、静脉曲张复发率以及下肢症状改善方面均显示出良好的临床效果。
