Complicated forms of varicose veins of the lower limbs : landmark method of surgical treatment
Science Articles / / August 12, 2017
Regional Hospital im.M.I.Kalinina, Samara
Introduction . According to various authors the frequency of varicose veins is currently ranges from 26-38% in women and 10-20 / about men.The share of the complicated forms of varicose veins (trophic ulcers, induration and pigmentation of the skin covering the lower leg) falls between 2 and 10%.The percentage of disability in this group of patients is from 52.6 to 67 / o.Treatment of these patients is one of the most important problems of modern surgery.
purpose and objectives of the study. Purpose - to improve the results of surgical treatment of complicated forms of varicose veins of the lower extremities.
1) conduct a retrospective analysis of surgical intervention;
2) to evaluate the results of surgical treatment.
Materials and methods. The Department of Vascular Surgery of the Samara Regional Clinical Hospital (SOKB) them.MIKalinin is currently adopted landmark method of surgical treatment of pati
Under the complicated forms of varicose veins is meant:
1) trophic ulcers on the medial surface of the tibia;
2) induration and pigmentation of the skin shin.Patients admitted to the Department, conducted general clinical research methods, as well as color Doppler mapping (CDM) of the lower extremities with the description of perforating veins.DRC performed pas apparatus Acuson Computed Sonography 128xp / 4 vein (GSV) on the confluence of the femoral vein to the area of trophic disorders in the leg (on Bebkokka procedure).Surgery was performed under intravenous anesthesia.In the postoperative period should be conservative therapy venotoniki, aggregation inhibitors, antihistamines, vitamins, topical treatment of venous ulcers.The average hospital stay did not exceed 7-10 days.In-patient treatment patients were to complete healing of venous disorders.
second phase of the operation: the removal of the distal great saphenous vein in the leg endoscopic intersection incompetent communicating veins (EG1KV).Endoscopy was performed on the stage equipment.Surgery was performed under general anesthesia.Postoperatively conducted conservative treatment, average hospital stay did not exceed 7-10 days.
When trophic violations within the boundaries of the lower third of the leg (or, in the absence of trophic ulcers) can do the surgery (the first stage venectomy with EBL) simultaneously.
results. From 2000 to 2003, 140 surgical operations performed compartment.Of these, the first stage 62 (44.28%), EBL 43 (30.72%), with the first stage venectomy EBL 35 (25 / o).Among patients 97 were women (69.28%), 43 men (30.72%) Recovery was observed in 125 (89.28%) patients.One patient died during surgery for acute myocardial infarction: one patient developed massive bleeding from the intersection of communicating veins.In 7 (5 w / v) of patients the first phase of venectomy not lead to healing of venous ulcers, which required the implementation EBL during the year, and in 6 (4.28 w / v) of patients - surgery Linton.
Clinical observations. Patient M., was treated at the Department of Vascular Surgery with the diagnosis: Varicose veins of right leg, decompensation stage.The trophic ulcer of right shin.He entered the Department of 05.06.2000 year.After preoperative preparation performed surgery: the first stage venectomy right (07.06.2000 year).The patient was discharged from the department on the third day after the operation (10.06.2000 year).After healing of trophic ulcers (a month) a patient enrolled in the second phase of surgery.13.07.2000, the patient performed EBL.The patient was discharged from the department on the sixth day after surgery (19.07.2000 year).Postoperative complications were observed.
Patient B., was treated in the department of vascular surgery with the diagnosis: Varicose veins left leg, decompensation stage.Induration of skin pigmentation and the lower third of the left tibia.I received branch 02.16.2002 year.After preoperative preparation performed surgery: the first stage venectomy with EBL (18.02.2002 year).The patient was discharged from the department on the fifth day after surgery (23.02.2002 year).Postoperative complications were observed.
Conclusion. use in the treatment of complicated forms of varicose veins of the lower extremities staged method of surgical treatment is the most promising and cost-effective.