腹腔镜下交通支静脉离断术治疗下肢浅静脉曲张

Subfascial endoscopic perforator surgery for superficial varicose veins in lower extremities

目的:探讨腹腔镜下交通支静脉离断术治疗下肢浅静脉曲张的优点、疗效及临床意义。方法:47例53条肢体腹腔镜下行深筋膜下交通支静脉离断术并行下肢大隐静脉高位或主干结扎及踝部结扎,曲张浅静脉分段剥除或缝扎。结果:术后浅静脉曲张消失,皮肤营养状况明显改善,皮炎7～21d治愈,8～31d溃疡愈合,无手术并发症。随访45条肢体,11～37个月,平均32个月无复发。结论:腹腔镜下交通支静脉离断术治疗下肢浅静脉曲张,疗效满意,能避免和减少术后复发,改善皮肤营养障碍,促进溃疡愈合,并发症少,并有微创效果。

Objective：To evaluate the advantages and clinical significance of subfaseial endoscopic perforator surgery （SEPS） under the guide of laparoscope for superficial varicose veins in lower extremities. Methods： Forty-seven patients（53 limbs） received SEPS by high figation of greater saphenous vein or ligating the major saphenous vein and the branches at ankle, phlebectomy or venisuture. Results： Subfascial varicose veins were cured in all patients and the skin in the lower limbs appeared in good condition. The dermatitis was controlled in 7 - 21days and the ulcer was healed in 8 -31 days, with no occurrence of post-operative complications. The follow-up of 45 limbs through 11 to 37 months, with an average of 32 months, found no relapse. Conclusion： SEPS may be effective for superficial varicose veins in the lower extremities with minireal invasion and less complications.