腔镜下大隐静脉隔绝术治疗大隐静脉曲张

目的:探讨腔镜下大隐静脉隔绝术治疗大隐静脉曲张的可行性及其疗效。方法:随机将2000年1月至2004年1月115例、132条下肢大隐静脉曲张患肢分为A、B两组,A组行腔镜下大隐静脉隔绝术,B组行传统的大隐静脉高位结扎剥脱术,对两种方法进行对比研究。结果:平均切口长度A组为(2. 0±0 .6)cm,B组为(8±1 .1)cm,平均切口长度A组明显短于B组(P<0 .05);平均手术时间A组为(35±10)min,B组为(90±17)min,手术时间A组明显短于B组(P<0 .05);术后两组症状消失,均未发生并发症;患者均获随访,随访1~36个月,A组无复发,B组局部复发4例,复发率6. 06%。结论:腔镜下大隐静脉隔绝术高位结扎、电灼大腿段大隐静脉,阻断其小腿段所有属支及交通支,使大隐静脉与体循环隔绝,不需抽剥大隐静脉,患者创伤小,疗效好,复发率低,是治疗大隐静脉曲张的理想术式。

Surgical treatment of varicosis of great saphenous vein by isolation of great saphenous vein through laparoscopy

Objective:To explore the feasibility and effect of the operation of isolation of great saphenous vein through laparoscopy.Methods:132 lower extremities with varicosis of great saphenous vein from 115 patients were divided into group A and group B randomly.The lower extremities in group A were performed the operation of isolation of great saphenous vein through laparoscopy,and those in group B received the traditional ligation and stripping of great varicose vein,and compared the effect of the two methods. Results:The mean length of incisions of group A was (2 0±0 6)cm, and that of group B was (8±1 1)cm, the mean length of incisions of group A was statistically shorter than that of group B(P<0 05);the mean operation time of group A was (35±10)min, and that of group B was (90±17)min, the mean time of group A was significantly shorter than that of group B(P<0 05).The symptoms of all cases in the two groups disappeared with no complication. All patients were followedup for l to 36 months,no patient in the group A recurred,and there were 6 patients in group B recurred(the recurrence rate was 6 06%). Conclusions: The operation of isolation of great saphenous vein through laparoscopy, by high ligation plus fulgerize the upper leg part and blocking all tributaries and communicating branch of its shank part, free from stripping great saphenous vein, belongs to minimally invasive operation,and has good curative effect with low recurrence rate.