MD539Z - Method for prevention of neovascularization after crossectomy - Google Patents
Method for prevention of neovascularization after crossectomy Download PDFInfo
- Publication number
- MD539Z MD539Z MDS20120017A MDS20120017A MD539Z MD 539 Z MD539 Z MD 539Z MD S20120017 A MDS20120017 A MD S20120017A MD S20120017 A MDS20120017 A MD S20120017A MD 539 Z MD539 Z MD 539Z
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- MD
- Moldova
- Prior art keywords
- stump
- saphenous vein
- sutured
- great saphenous
- region
- Prior art date
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- 238000000034 method Methods 0.000 title claims abstract description 11
- 206010029113 Neovascularisation Diseases 0.000 title claims abstract description 10
- 230000002265 prevention Effects 0.000 title abstract 2
- 210000003752 saphenous vein Anatomy 0.000 claims abstract description 22
- 210000003191 femoral vein Anatomy 0.000 claims abstract description 5
- 238000002695 general anesthesia Methods 0.000 claims abstract description 5
- 238000002690 local anesthesia Methods 0.000 claims abstract description 5
- 230000001483 mobilizing effect Effects 0.000 claims description 3
- 238000007493 shaping process Methods 0.000 claims description 3
- 239000003814 drug Substances 0.000 abstract description 2
- 238000001356 surgical procedure Methods 0.000 abstract description 2
- 208000027185 varicose disease Diseases 0.000 description 9
- 206010046996 Varicose vein Diseases 0.000 description 5
- 210000003038 endothelium Anatomy 0.000 description 5
- 201000002282 venous insufficiency Diseases 0.000 description 5
- 230000002980 postoperative effect Effects 0.000 description 4
- 206010033675 panniculitis Diseases 0.000 description 3
- 210000004003 subcutaneous fat Anatomy 0.000 description 3
- 239000002870 angiogenesis inducing agent Substances 0.000 description 2
- 201000002816 chronic venous insufficiency Diseases 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 238000009556 duplex ultrasonography Methods 0.000 description 2
- 230000003511 endothelial effect Effects 0.000 description 2
- 210000003141 lower extremity Anatomy 0.000 description 2
- 230000001575 pathological effect Effects 0.000 description 2
- 238000011477 surgical intervention Methods 0.000 description 2
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000002682 general surgery Methods 0.000 description 1
- LELAOEBVZLPXAZ-UHFFFAOYSA-N iberin Chemical compound CS(=O)CCCN=C=S LELAOEBVZLPXAZ-UHFFFAOYSA-N 0.000 description 1
- 208000028867 ischemia Diseases 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
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- Materials For Medical Uses (AREA)
Abstract
Description
Invenţia se referă la medicină, în special la chirurgie şi poate fi utilizată pentru prevenirea neovascularizării după crossectomie. The invention relates to medicine, in particular to surgery, and can be used to prevent neovascularization after crossectomy.
Este cunoscută metoda de prevenire a neovascularizării după crossectomie, care constă în aceea că se efectuează anestezia locală sau generală, se efectuează o incizie de 3…4 cm în regiunea plicii inghinale, se secţionează toate tributările venoase în regiunea joncţiunii safeno-femurale, se mobilizează şi se secţionează vena safenă mare nemijlocit la locul revărsării în vena femurală comună, după care bontul venei safene mari se ligaturează [1]. The method of preventing neovascularization after crossectomy is known, which consists in performing local or general anesthesia, making a 3…4 cm incision in the inguinal fold region, cutting all venous tributaries in the region of the saphenofemoral junction, mobilizing and cutting the great saphenous vein directly at the site of its outflow into the common femoral vein, after which the stump of the great saphenous vein is ligated [1].
Dezavantajele acestei metode constau în existenţa contactului direct între endoteliul bontului venei safene mari şi ţesutul adipos subcutanat în regiunea inghinală. Ligatura bontului venei safene mari duce la ischemia endoteliului şi eliberarea factorilor endoteliali de angiogeneză. Sub acţiunea factorilor endoteliali de angiogeneză se formează o reţea de vase venoase noi ce reuneşte din nou bontul venei safene mari cu venele superficiale ale membrului inferior operat (fenomenul de neovascularizare inghinală). În perioada postoperatorie îndepărtată se poate declanşa reapariţia refluxului venos în regiunea joncţiunii safeno-femurale şi recurenţa maladiei varicoase. The disadvantages of this method are the existence of direct contact between the endothelium of the great saphenous vein stump and the subcutaneous adipose tissue in the inguinal region. Ligation of the great saphenous vein stump leads to ischemia of the endothelium and the release of endothelial angiogenesis factors. Under the action of endothelial angiogenesis factors, a network of new venous vessels is formed, which reunites the great saphenous vein stump with the superficial veins of the operated lower limb (the phenomenon of inguinal neovascularization). In the distant postoperative period, the reappearance of venous reflux in the region of the saphenofemoral junction and the recurrence of varicose disease may be triggered.
Problema pe care o rezolvă invenţia propusă constă în izolarea endoteliului bontului venei safene mari de ţesutul adipos subcutanat în regiunea inghinală. The problem solved by the proposed invention consists in isolating the endothelium of the great saphenous vein stump from the subcutaneous adipose tissue in the inguinal region.
Conform invenţiei, metoda revendicată constă în aceea că se efectuează anestezia locală sau generală, se efectuează o incizie de 3…4 cm în regiunea plicii inghinale, se secţionează toate tributările venoase în regiunea joncţiunii safeno-femurale, se mobilizează şi se secţionează vena safenă mare nemijlocit la locul revărsării în vena femurală comună, după care bontul venei safene mari se ligaturează. Suplimentar, marginile libere ale bontului se suturează spre centru modelând bontul în formă de 8, totodată colţurile bontului se tracţionează spre centrul bontului şi se fixează cu acelaşi fir, după care plaga se suturează pe straturi. According to the invention, the claimed method consists in performing local or general anesthesia, making a 3…4 cm incision in the inguinal fold region, cutting all venous tributaries in the saphenofemoral junction region, mobilizing and cutting the great saphenous vein directly at the place of its outflow into the common femoral vein, after which the stump of the great saphenous vein is ligated. Additionally, the free edges of the stump are sutured towards the center, shaping the stump in the shape of an 8, at the same time the corners of the stump are pulled towards the center of the stump and fixed with the same thread, after which the wound is sutured in layers.
Metoda revendicată este simplă şi rapidă în realizare, poate fi aplicată în orice diametru al bontului venei safene mari şi, prin izolarea sigură a endoteliului, previne dezvoltarea recidivelor maladiei varicoase. The claimed method is simple and quick to perform, can be applied to any diameter of the great saphenous vein stump and, by safely isolating the endothelium, prevents the development of varicose vein recurrences.
Rezultatul constă în izolarea endoteliului bontului venei safene mari de ţesutul adipos subcutanat şi prevenirea fenomenului de neovascularizare inghinală şi a recurenţei postoperatorii a maladiei varicoase. The result consists in isolating the endothelium of the great saphenous vein stump from the subcutaneous adipose tissue and preventing the phenomenon of inguinal neovascularization and postoperative recurrence of varicose disease.
Metoda de prevenire a neovascularizării după crossectomie şi apariţiei recidivelor de boală varicoasă se realizează în modul următor: se efectuează anestezia locală sau generală, se efectuează o incizie de 3…4 cm în regiunea plicii inghinale, se secţionează toate tributările venoase în regiunea joncţiunii safeno-femurale, se mobilizează şi se secţionează vena safenă mare nemijlocit la locul revărsării în vena femurală comună, după care bontul venei safene mari se ligaturează, totodată, marginile libere ale bontului se suturează spre centru modelând bontul în formă de 8, iar colţurile bontului se tracţionează spre centrul bontului şi se fixează cu acelaşi fir, excesul firului se taie, după care plaga se suturează pe straturi. Se aplică un pansament aseptic pe plagă şi un bandaj compresiv pe membrul inferior. The method of preventing neovascularization after crossectomy and the occurrence of varicose disease recurrences is carried out as follows: local or general anesthesia is performed, a 3…4 cm incision is made in the inguinal fold region, all venous tributaries in the saphenofemoral junction region are sectioned, the great saphenous vein is mobilized and sectioned directly at the place of overflow into the common femoral vein, after which the stump of the great saphenous vein is ligated, at the same time, the free edges of the stump are sutured towards the center, shaping the stump in the shape of an 8, and the corners of the stump are pulled towards the center of the stump and fixed with the same thread, the excess thread is cut, after which the wound is sutured in layers. An aseptic dressing is applied to the wound and a compression bandage is applied to the lower limb.
Exemplul 1 Example 1
Pacienta L., în vârstă de 46 ani. Diagnosticul: maladie varicoasă, varice în bazinul venei safene mari pe stânga, insuficienţă venoasă cronică C2. La ultrasonografia Doppler-duplex s-a determinat incompetenţa aparatului valvular la nivelul joncţiunii safeno-femurale cu reflux venos patologic în vena safenă mare. Diametrul venei safene constituie 0,8 cm. S-a efectuat intervenţia chirurgicală prin metoda revendicată. Perioada postoperatorie precoce cu evoluţie satisfăcătoare, fără complicaţii. La examenul clinic şi ultrasonor la 2 ani după operaţie fenomenul de neovascularizare inghinală şi recurenţa maladiei varicoase nu s-au depistat. Patient L., 46 years old. Diagnosis: varicose veins, varicose veins in the basin of the great saphenous vein on the left, chronic venous insufficiency C2. Doppler-duplex ultrasonography determined the incompetence of the valvular apparatus at the level of the saphenofemoral junction with pathological venous reflux into the great saphenous vein. The diameter of the saphenous vein is 0.8 cm. The surgical intervention was performed using the claimed method. The early postoperative period with satisfactory evolution, without complications. At the clinical and ultrasound examination 2 years after the operation, the phenomenon of inguinal neovascularization and recurrence of varicose veins were not detected.
Exemplul 2 Example 2
Pacienta C., în vârstă de 57 ani. Diagnosticul: maladie varicoasă, varice în bazinul venei safene mari pe stânga, insuficienţă venoasă cronică C6. La ultrasonografia Doppler-duplex s-a determinat incompetenţa aparatului valvular la nivelul joncţiunii safeno-femurale cu reflux venos patologic în vena safenă mare. Diametrul venei safene constituie 0,15 cm. S-a efectuat intervenţia chirurgicală prin metoda revendicată. Perioada postoperatorie precoce cu evoluţie satisfăcătoare, fără complicaţii. Patient C., 57 years old. Diagnosis: varicose disease, varicose veins in the basin of the great saphenous vein on the left, chronic venous insufficiency C6. Doppler-duplex ultrasonography determined valvular incompetence at the saphenofemoral junction with pathological venous reflux into the great saphenous vein. The diameter of the saphenous vein is 0.15 cm. The surgical intervention was performed using the claimed method. The early postoperative period was satisfactory, without complications.
Metoda a fost aplicată la 20 de bolnavi, în cadrul Clinicii de Chirurgie Generală şi Semiologie, IMSP Spitalul Clinic Municipal nr.1. În perioada de supraveghere de la 1 până la 2 ani, nu s-au înregistrat semne clinice şi ultrasonografice de recurenţă a maladiei varicoase, provocată de fenomenul de neovascularizare inghinală. The method was applied to 20 patients, within the Clinic of General Surgery and Semiology, IMSP Municipal Clinical Hospital No. 1. During the surveillance period from 1 to 2 years, no clinical and ultrasonographic signs of recurrence of varicose disease, caused by the phenomenon of inguinal neovascularization, were recorded.
1. Kingsnorth A. N., Majid A. A. Fundamentals of Surgical Practice. Second edition. Cambrige University Press, 2006, p. 300 1. Kingsnorth A.N., Majid A.A. Fundamentals of Surgical Practice. Second edition. Cambridge University Press, 2006, p. 300
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Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20120017A MD539Z (en) | 2012-01-26 | 2012-01-26 | Method for prevention of neovascularization after crossectomy |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20120017A MD539Z (en) | 2012-01-26 | 2012-01-26 | Method for prevention of neovascularization after crossectomy |
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| Publication Number | Publication Date |
|---|---|
| MD539Y MD539Y (en) | 2012-08-31 |
| MD539Z true MD539Z (en) | 2013-03-31 |
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| Application Number | Title | Priority Date | Filing Date |
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| MDS20120017A MD539Z (en) | 2012-01-26 | 2012-01-26 | Method for prevention of neovascularization after crossectomy |
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Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD634Z (en) * | 2012-09-26 | 2013-12-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Endovascular method for treatment of varicose disease |
Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2128476C1 (en) * | 1995-04-24 | 1999-04-10 | Александр Григорьевич Лымарь | Method for treating varicose disease of lower extremities |
| RU2147849C1 (en) * | 1999-05-12 | 2000-04-27 | Медицинский центр банка России | Surgical method for treating varicose disease with high power laser |
| MD2328F1 (en) * | 2003-07-14 | 2003-12-31 | Constantin Tibirna | Fibrinous adhesive and use thereof for endoscopic hemostasis of variceal hemorrhages in hepatic cirrhosis |
| RU2242182C1 (en) * | 2003-07-31 | 2004-12-20 | Иркутский государственный институт усовершенствования врачей | Method for suturing subfascial access in the cases of varicose and posttraumatic disease accompanied by chronic venous insufficiency of lower extremities |
| RU2301069C2 (en) * | 2004-06-10 | 2007-06-20 | Муниципальное учреждение здравоохранения "Городская клиническая больница №3" | Method for treating complicated varicose and post-thrombophlebitic disease cases |
| MD343Y (en) * | 2010-11-30 | 2011-03-31 | Viorel Moraru | Method for prevention of secondary rectal varicose formation in patiens with splenomegaly in cirrhogenic portal hypertension |
| MD344Y (en) * | 2010-11-30 | 2011-03-31 | Gheorghe Anghelici | Method for treating varicose rectal hemorrhages in patients with liver cirrhosis |
| MD370Y (en) * | 2010-11-30 | 2011-05-31 | Oleg Crudu | Method for treatment of varicose rectal hemorrhages in cirrhogenic portal hypertension |
-
2012
- 2012-01-26 MD MDS20120017A patent/MD539Z/en not_active IP Right Cessation
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2128476C1 (en) * | 1995-04-24 | 1999-04-10 | Александр Григорьевич Лымарь | Method for treating varicose disease of lower extremities |
| RU2147849C1 (en) * | 1999-05-12 | 2000-04-27 | Медицинский центр банка России | Surgical method for treating varicose disease with high power laser |
| MD2328F1 (en) * | 2003-07-14 | 2003-12-31 | Constantin Tibirna | Fibrinous adhesive and use thereof for endoscopic hemostasis of variceal hemorrhages in hepatic cirrhosis |
| RU2242182C1 (en) * | 2003-07-31 | 2004-12-20 | Иркутский государственный институт усовершенствования врачей | Method for suturing subfascial access in the cases of varicose and posttraumatic disease accompanied by chronic venous insufficiency of lower extremities |
| RU2301069C2 (en) * | 2004-06-10 | 2007-06-20 | Муниципальное учреждение здравоохранения "Городская клиническая больница №3" | Method for treating complicated varicose and post-thrombophlebitic disease cases |
| MD343Y (en) * | 2010-11-30 | 2011-03-31 | Viorel Moraru | Method for prevention of secondary rectal varicose formation in patiens with splenomegaly in cirrhogenic portal hypertension |
| MD344Y (en) * | 2010-11-30 | 2011-03-31 | Gheorghe Anghelici | Method for treating varicose rectal hemorrhages in patients with liver cirrhosis |
| MD370Y (en) * | 2010-11-30 | 2011-05-31 | Oleg Crudu | Method for treatment of varicose rectal hemorrhages in cirrhogenic portal hypertension |
Non-Patent Citations (3)
| Title |
|---|
| Kingsnorth A. N., Majid A. A. Fundamentals of Surgical Practice. Second edition. Cambrige University Press, 2006, p. 300 * |
| MD 344 Y 2011.03.31 * |
| MD 370 Y 2011.05.31 * |
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| Publication number | Publication date |
|---|---|
| MD539Y (en) | 2012-08-31 |
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