Stripping operation with preservation of the calf saphenous veins for primary varicose veins: hemodynamic evaluation

Toshiya Nishibe , Masayasu Nishibe , Fabio Kudo , Jorge Flores , Keiko Miyazaki , Keishu Yasuda
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Abstract

Purpose. To study early changes in venous hemodynamics in stripping operation with preservation of the calf saphenous veins.

Patients and methods. From October 1999 to December 2000, 110 extremities of 73 patients were treated for primary varicose veins. Based on preoperative ascending venography, 40 extremities underwent the groin-to-knee stripping of the GSV, 20 underwent the proximal division of the LSV, and 50 received combinations of both surgeries. To evaluate venous hemodynamic changes, air plethysmography was performed before operation and 7–14 days after operation.

Results. The venous volume, venous filling index and residual volume fraction were improved after surgery, but the ejection fraction did not change. The overall incidence of nerve injury was 4.5% (five limbs).

Conclusions. In stripping operations, the preservation of the calf saphenous veins, which is shown to be advantageous in reducing saphenous or sural nerve injuries, does not adversely affect early venous hemodynamic improvement.

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保留小腿隐静脉的剥脱术治疗原发性静脉曲张:血流动力学评价
目的。目的:探讨保留小腿隐静脉的剥离手术早期静脉血流动力学的变化。患者和方法。1999年10月至2000年12月,对73例原发性静脉曲张患者110条肢体进行了治疗。根据术前升静脉造影,40例患者接受了腹股沟至膝关节的GSV剥离术,20例接受了LSV近端分离术,50例接受了两种手术的联合。术前及术后7 ~ 14天分别行空气容积描记术评价静脉血流动力学变化。术后静脉体积、静脉充盈指数和残余体积分数均有改善,但射血分数无变化。神经损伤的总发生率为4.5%(5肢)。在剥离手术中,保留小腿隐静脉有利于减少隐静脉或腓肠神经损伤,不会对早期静脉血流动力学改善产生不利影响。
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