Endoscope-Assisted Surgery for Management of Varicosity in Klippel-Trenaunay Syndrome-A Case Report

內視鏡輔助移除Klippel-Trenaunay綜合症靜脈曲張的病例報告

林運男(Yun-Nan Lin) ； 林幸道(Sin-Daw Lin) ； 張高評(Kao-Ping Chang)

《臺灣整形外科醫學會雜誌》 22卷4期 (2013/12) Pp. 314-320

摘要

背景：Klippel-Trenaunay綜合症（KTS）是一個罕見且隨機發生的血管畸形疾病，它有三個典型病徵，分別是微血管畸形、非典型側肢靜脈曲張和軟組織或硬骨的增生。95%的KTS患者大多是單側下肢的畸形，伴有側肢靜脈曲張的問題，治療多半是保守性的治療。目的及目標：傳統治療的結果復發率高。我們報告的案例是在內視鏡儀器輔助手術移除KTS患者的曲張靜脈。材料及方法：一位32歲女性自幼即有KTS的病徵，因為右下肢的疼痛腫脹變形來求診，術前詳細檢查，包括MRI，在確定deep vein system沒病變下，經由醫師詳盡解釋後，進行內視鏡儀器輔助手術，手術中可清楚且確實的移除KTS患者的右下肢外側曲張靜脈和功能不全的穿透枝。結果：術後病人的臨床疼痛症狀和下肢特有且怪異的靜脈曲張的情況明顯改善，經三次手術，術後追蹤的MRI顯示靜脈曲張大幅度的改善，術後門診追蹤8個月，患者對於手術的成果感到相當的滿意。結論：移除KTS患者的曲張靜脈，以內視鏡儀器輔助手術提供了另一個可選擇、好的手術方式。

並列摘要

Background:Klippel-Trenaunay syndrome (KTS) is a rare and complex vascular malformation. The syndrome is usually managed conservatively by treating venous anomalies and by orthopedic management of unequal limb lengths. However, conventional surgical management of this venous anomalies has a high recurrence rate due to erratic abnormalities in the extension and location of varicosity.Aim and Objectives:Through endoscope-assisted removal of causative vein surgery, we could adequately remove the atypical lateral varicosity of KTS.Materials and Methods:We reported a 32-year-old woman with symptomatic varicosity of KTS over her right lower limb. After comprehensive evaluations of venous abnormalities, including echography and MRI, endoscope-assisted surgery was performed. Postoperative MRI was evaluated to examine the results.Results:After three times of surgery, postoperative MRI confirmed adequate removal of superficial varicosity in the lateral aspect of the right lower limb. The patient was satisfied with the postoperative pain relief and cosmetic improvement in her right lower limb.Conclusion:Endoscope-assisted surgery provided an alternative method for KTS patients to relieve their symptoms.

並列關鍵字

Klippel-Trenaunay syndrome ； endoscopic surgery ； varicosity