Results of stripping operation for varicose veins

Approximately 150 stripping operations for primary varicose veins of the lower extremities were performed. Long-term evaluation (post-operative follow-up of more than five years) was made on 102 extremities and 83 per cent of these showed good or excellent results. Six patients were reoperated due to recurrence of varices. Accurate diagnosis and complete operation are most important in stripping operations.     

Results of stripping operation for varicose veins.

Approximately 150 stripping operations for primary varicose veins of the lower extremities were performed. Long-term evaluation (postoperative follow-up of more than five years) was made on 102 extremities and 83 per cent of these showed good or excellent results. Six patients were reoperated due to recurrence of varices. Accurate diagnosis and complete operation are most important in stripping operations.     

Endovenous therapy for varicose veins of the lower extremities

Endovenous treatment for varicose veins of the lower extremities is an old technique. New technologies such as radiofrequency and laser have revived its indications. Thermal energy which is delivered to the vein wall results in a fibrous retraction and eventually complete obstruction of the vessel.     

腔内激光和传统手术治疗下肢静脉曲张的临床疗效比较

目的比较静脉腔内激光（EVLT）和传统手术治疗下肢静脉曲张的疗效。方法分析2002年1月至2005年12月间在我科行传统手术治疗下肢静脉曲张患者100例（128条患肢）以及行EVLT治疗的患者120例（160条患肢）,比较患者手术前后主观感受改善程度（皮肤瘙痒、下肢酸胀沉重感等）、手术时间、手术切口数量、术后疼痛、术后并发症、住院时间、住院费用、1年复发率等八项指标。结果EVLT组在手术时间、手术切口数量、术后疼痛、术后并发症、术后住院时间、住院费用等六个方面明显优于传统手术组,而手术前后主观感受改善程度、1年复发率与传统手术组差异无统计学意义。结论EVLT是一种安全、有效的微创治疗方法,不留手术瘢痕,有望代替传统手术应用于下肢静脉曲张的治疗,扩大了传统手术的适应证。同时,EVLT还具有良好的卫生经济学前景。     

静脉腔内激光治疗下肢静脉曲张的疗效观察

目的　评价静脉腔内激光治疗下肢静脉曲张的疗效。方法　 46例患者共 5 4条患肢行单纯激光治疗或大隐静脉高位结扎加激光治疗。结果　所有患者的静脉曲张均闭塞。 19.5 %患者出现肢体淤斑 ,81.5 %患者肢体发生沿大隐静脉行程条索状硬结或硬块 ,11.1%患者皮肤局部麻木 ,1例患者发生皮肤浅表烧伤。所有患者均获随访 ,平均随访 6个月 (3～ 8个月 ) ,均痊愈。无深静脉血栓 ,无局部复发 ,疗效满意。结论　静脉腔内激光治疗是一种安全、有效、微创的治疗方法 ,选择大隐静脉高位结扎加激光治疗则更安全。     

Accuracy of hand-held Doppler in planning the operation for primary varicose veins.

OBJECTIVE: To evaluate whether hand-held Doppler (HHD) examination is an adequate screening test in planning surgical treatment for primary varicose vein. DESIGN: Prospective study. MATERIALS: One hundred and eleven consecutive patients (142 legs) with primary, uncomplicated varicose veins. METHODS: Legs were examined clinically, with HHD and duplex ultrasonography on the same day at the outpatient clinic. The plan for the subsequent treatment was recorded separately after each examination. RESULTS: At the sapheno-femoral junction and at the sapheno-popliteal junction, the sensitivity was 56 and 23%, the specificity 97 and 96%, the positive predictive values was 98 and 43%, the negative predictive value was 44 and 91%, and the Kappa coefficient was 38 and 24%, respectively. Clinical examination failed to correctly plan the treatment in 21 (26%) of 80 proposed operations. In 13 limbs (9.1%) the HHD-based treatment plan was modified on the basis of duplex ultrasound findings. In seven cases, patients would have undergone only stab avulsion procedure, whereas stripping of a saphenous vein was indicated on the basis of duplex ultrasound findings. In two other cases, HHD findings would have led to resect the wrong saphenous vein. In six cases, the treatment was wrongly planned because of assessment problems during HHD examination at the popliteal fossa. CONCLUSIONS: The accuracy of HHD in the preoperative evaluation of primary, uncomplicated varicose veins is unsatisfactory. These results suggest that duplex ultrasonography should be considered as the preoperative diagnostic method of choice.