腔内激光联合点式潜行剥脱治疗下肢浅静脉曲张——五年随访报告

目的：应用腔内激光（EVLT）联合点式潜行剥脱治疗下肢浅静脉曲张,通过5年随访评价其远期疗效。方法：收治下肢浅静脉曲张患者56例,共88条患肢。行常规EVLT,并同期利用腹腔镜手术分离钳进行点式潜行曲张静脉团剥脱。结果：手术时间平均45 min,失血平均70 mL。5年随访发现静脉曲张复发6例（10.7%）,再次手术4例（7.1%）,3例术后大隐静脉根部未完全闭塞,另3例为交通支原因复发。结论：ELVT联合点式潜行剥脱治疗下肢静脉曲张相对简单、微创效果好、远期疗效较好,复发率尚可接受。

Endovenous laser treatment combined with stab avulsion technique for the saphenous vein:outcome and recurrence after 5 years

Objective： Endovenous laser treatment combined with stab avulsion technique was used for the varicose veins of the saphenous vein.The clinical outcome and recurrence was assessed after 5 years.Methods： A total of 56 patients（88 legs）were treated with the procedure.In the procedure,the conventional EVLT was conducted first and followed by stab avulsions of varicose veins using a laparoscopic dissecting forceps.Results： The mean operating time was 45 min and the mean blood loss was 70 mL.After 5 years,a total of 6 patients（10.7%）developed recurrent varicose veins.Among them,4 patients accepted reoperation.The reasons of recurrence included： the root of the great saphenous vein was not completely occluded in 3 patients,and communicating branches opened in the other 3 patients.Conclusion： The technique is relatively simple with a perfect cosmetic result,better outcome,and acceptable long-term recurrence.Attention should be focused on reliable EVLT on the root level of the great saphenous vein,effective postoperative pressing measure of the limb and clearly elimination of the communicating branches.