Surgical treatment of recurrences of varicose veins of the lower extremities

Operations for recurrent varicosities were made in 48 patients. Extravasal correction of the femoral vein valves, dissection of the popliteal vein aneurysms and ligation of the communicatory veins were also performed in addition to the extirpation of dilated subcutaneous veins.     

Surgical treatment of recurrence of the varicose veins in the lower extremities

The results of treatment in 1080 patients with the lower extremities varicose disease (VD) were analyzed. For the subcutaneous veins recurrent varicose (SVV) there were operated 11.2% patients, including, once--76.1%, twice--17.4%, three times--6.5%. In all 146 the operations were performed. Sclerosing therapy of SVV was applied in 21 patients. Basic mistake during performance of the first operative intervention for the VD was insufficient evaluation of character of the blood outflow disorder.     

Surgical treatment of initial forms of varicose veins of the lower extremities

Experience in the treatment of 386 patients with stage 2-3 of varicose disease is analyzed. There are five main variants of surgical treatment in these patients: combined phlebectomy, sclero-obliteration of the trunk, short stripping with ligation of insufficient perforant veins, short stripping with excision or destruction of varicose branches, short stripping and sclero-obliteration of the trunk. It is demonstrated that minimally invasive surgical procedures decrease the number of postoperative subcutaneous haematomas, ensure good cosmetic effect, allow to avoid an injury of n.saphenus and lymphorrhea. It is concluded that minimally invasive surgical procedures may be used for treatment of initial forms of varicose disease.     

Pathogenesis of trophic ulcers in varicose veins of the lower extremities]

The work generalized the results of examination of 418 patients with primary varicosity (V) complicated by trophic ulcers. On the basis of the study conducted by the authors, a conception of pathogenesis is suggested, the main links of which are microcirculatory disorders in the system of perforating veins of a closed structure, and deficient resolution of fibrin due to diminished local fibrinolytic activity of the plasma. Insufficient fibrin splitting leads to the formation of paravasal collagen cuffs preventing normal exchange between the capillaries and tissues. Impaired nutrition facilitates spasm of arteries and arterioles, whose genesis magnesium deficit contributes to. Activation of collagenolytic peptidases-cathepsins, D, A, B occurs in the ischemic tissues, which leads to destruction of the skin and the formation of ulcers. The disease is attended by disorders of immunity (secondary immunodeficiency), which reduces the reparative processes and thus promotes the development of a chronic process. A complex approach to the treatment of V in the presence of trophic ulcers is suggested.     

Surgical treatment of varicose veins of the lower extremities in a polyclinic]

The authors discuss the results of 40 operations carried out in the outpatient clinic for varicosity of the lower limb veins. The number of complications did not exceed that in operations performed in the inpatient clinic. The home conditions, the absence of a possible intrahospital infection, and the increased motor activity help in rapid rehabilitation of the patients. The period of working disability is significantly reduced.     

静脉腔内激光治疗下肢静脉曲张的疗效观察

目的　评价静脉腔内激光治疗下肢静脉曲张的疗效。方法　 46例患者共 5 4条患肢行单纯激光治疗或大隐静脉高位结扎加激光治疗。结果　所有患者的静脉曲张均闭塞。 19.5 %患者出现肢体淤斑 ,81.5 %患者肢体发生沿大隐静脉行程条索状硬结或硬块 ,11.1%患者皮肤局部麻木 ,1例患者发生皮肤浅表烧伤。所有患者均获随访 ,平均随访 6个月 (3～ 8个月 ) ,均痊愈。无深静脉血栓 ,无局部复发 ,疗效满意。结论　静脉腔内激光治疗是一种安全、有效、微创的治疗方法 ,选择大隐静脉高位结扎加激光治疗则更安全。     

下肢静脉曲张治疗现状

该文就大隐静脉曲张的传统手术治疗、缝扎法治疗、点式剥脱法、瓣膜成形术、硬化剂注射治疗、电凝法治疗、激光治疗等方法进行综述，指出大隐静脉曲张的治疗以手术为主，电凝、硬化剂、激光等新的治疗方法则更倾向于微创和经济。