Lacroix H, Smeets A, Nevelsteen A, Suy R
Department of Vascular Surgery, UZ Gasthuisberg, Leuven, Belgium.
Acta Chir Belg. 1998 Mar-Apr;98(2):71-5.
In this retrospective non-randomized study the results of the FELDER technique (n = 29) were compared to two endoscopic techniques for ligation of incompetent perforating veins: using a mediastinoscope (n = 19) and laparoscopic instruments (n = 57). The indication was a venous ulcer in nine, five and thirteen patients respectively, lipodermatosclerosis in thirteen, five and twenty-four, and simple varicose veins in the remaining patients (NS).
The mean number of interrupted perforating veins was 4.2, 2.4 and 3.8 (p < 0.05). The mean hospital stay was 3.5, 1.9 and 1.6 days (p < 0.0001). The mean period of convalescence was 8.7, 4.1 and 3.7 weeks (NS). The number of complications was 9 (suralis lesion 4, pain/swelling 4, wound problem 1), 6 (saphenous lesion 3, pain/swelling 3) and 15 (pain/swelling 14, deep venous thrombosis 1) (NS). Ten patients were lost to follow-up (five, two and three). Respectively 19, 12 and 45 patients were satisfied with the end-result. The condition had worsened in one, two and three patients (NS). During the short follow-up period all ulcers healed and there was no recurrence.
The endoscopic techniques produce results comparable to the FELDER procedure, with smaller scars and a tendency towards a faster recovery.
在这项回顾性非随机研究中，将费尔德技术（n = 29）的结果与两种用于结扎功能不全穿通静脉的内镜技术进行比较：使用纵隔镜（n = 19）和腹腔镜器械（n = 57）。适应症分别为9例、5例和13例静脉溃疡患者，13例、5例和24例脂膜炎患者，其余患者为单纯静脉曲张（无统计学差异）。
中断的穿通静脉平均数量分别为4.2、2.4和3.8（p < 0.05）。平均住院时间分别为3.5天、1.9天和1.6天（p < 0.0001）。平均康复期分别为8.7周、4.1周和3.7周（无统计学差异）。并发症数量分别为9例（腓肠神经损伤4例、疼痛/肿胀4例、伤口问题1例）、6例（大隐静脉损伤3例、疼痛/肿胀3例）和15例（疼痛/肿胀14例、深静脉血栓形成1例）（无统计学差异）。10例患者失访（分别为5例、2例和3例）。分别有19例、12例和45例患者对最终结果满意。1例、2例和3例患者病情恶化（无统计学差异）。在短期随访期间，所有溃疡均愈合且无复发。
内镜技术产生的结果与费尔德手术相当，疤痕更小且恢复倾向更快。
