...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of vascular surgery >Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial endoscopic perforator surgery registry. The North American Study Group.
【24h】

Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial endoscopic perforator surgery registry. The North American Study Group.

机译：内窥镜穿孔器静脉中断治疗慢性静脉功能不全的中期结果：从北美筋膜下内窥镜穿孔器手术注册处获得的经验教训。北美研究小组。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

PURPOSE: The safety, feasibility, and early efficacy of subfascial endoscopic perforator surgery (SEPS) for the treatment of chronic venous insufficiency were established in a preliminary report. The long-term clinical outcome and the late complications after SEPS are as yet undetermined. METHODS: The North American Subfascial Endoscopic Perforator Surgery registry collected information on 148 SEPS procedures that were performed in 17 centers in the United States and Canada between August 1, 1993, and February 15, 1996. The data analysis in this study focused on mid-term outcome in 146 patients. RESULTS: One hundred forty-six patients (79 men and 67 women; mean age, 56 years; range, 27 to 87 years) underwent SEPS. One hundred and one patients (69%) had active ulcers (class 6), and 21 (14%) had healed ulcers (class 5). One hundred and three patients (71%) underwent concomitant venous procedures (stripping, 70; high ligation, 17; varicosity avulsion alone, 16). There were no deaths or pulmonary embolisms. One deep venous thrombosis occurred at 2 months. The follow-up periods averaged 24 months (range, 1 to 53 months). Cumulative ulcer healing at 1 year was 88% (median time to healing, 54 days). Concomitant ablation of superficial reflux and lack of deep venous obstruction predicted ulcer healing (P <.05). Clinical score improved from 8.93 to 3.98 at the last follow-up (P <. 0001). Cumulative ulcer recurrence at 1 year was 16% and at 2 years was 28% (standard error, < 10%). Post-thrombotic limbs had a higher 2-year cumulative recurrence rate (46%) than did those limbs with primary valvular incompetence (20%; P <.05). Twenty-eight of the 122 patients (23%) who had class 5 or class 6 ulcers before surgery had an active ulcer at the last follow-up examination. CONCLUSIONS: The interruption of perforators with ablation of superficial reflux is effective in decreasing the symptoms of chronic venous insufficiency and rapidly healing ulcers. Recurrence or new ulcer development, however, is still significant, particularly in post-thrombotic limbs. The reevaluation of the indications for SEPS is warranted because operations in patients without previous deep vein thrombosis are successful but operations in those patients with deep vein thrombosis are less successful. Operations on patients with deep vein occlusion have poor outcomes.
机译：目的：在初步报告中确定了筋膜下内窥镜穿孔手术（SEPS）治疗慢性静脉功能不全的安全性，可行性和早期疗效。 SEPS术后的长期临床结果和晚期并发症尚未确定。方法：1993年8月1日至1996年2月15日在美国和加拿大的17个中心进行的北美筋膜下内镜穿支镜穿孔手术注册中心收集了148例SEPS程序的信息。本研究的数据分析集中于146例患者的足月结局。结果：146例患者（79例男性和67例女性;平均年龄56岁;范围27至87岁）接受了SEPS。一百零一例患者（69％）患有活动性溃疡（6级），而21例（14％）具有治愈性溃疡（5级）。一百零三名患者（71％）接受了静脉手术（剥离，70例;高结扎，17例;仅​​静脉曲张撕脱，16例）。没有死亡或肺栓塞。 2个月时发生1例深静脉血栓形成。随访时间平均为24个月（范围为1到53个月）。 1年时溃疡的累计愈合率为88％（中位愈合时间为54天）。浅表反流的同时消融和深静脉阻塞的缺乏可预测溃疡愈合（P <.05）。在最后一次随访中，临床评分从8.93提高到3.98（P <.0001）。 1年的累积溃疡复发率为16％，2年的累积复发率为28％（标准误，<10％）。血栓形成后肢体的2年累积复发率（46％）高于原发性瓣膜功能不全的肢体（20％; P <.05）。在手术前患有5级或6级溃疡的122位患者中，有28位（23％）在上次随访检查中出现了活动性溃疡。结论：中断穿刺并消融浅表反流可有效减轻慢性静脉功能不全和溃疡快速愈合的症状。然而，复发或新的溃疡发展仍然很重要，特别是在血栓形成后的肢体中。 SEPS适应症的重新评估是有必要的，因为先前没有深静脉血栓形成的患者的手术成功，而对于深静脉血栓形成的患者的手术则不太成功。深静脉阻塞患者的手术效果差。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号