RU2137423C1 - Surgical method for treating varicose lower extremity veins - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves using autovein for achieving occlusion. Venous trunk portion to be implanted is immersed into antiseptic solution. Varicose changed trunks are occluded in trophic disorder zones. EFFECT: reduced risk of complications.

Description

 The invention relates to medicine, namely surgery, and can be used in the surgical treatment of varicose veins.

 There is a method of surgical treatment of varicose veins ([1] - analogue), which consists in the fact that the desolation and sclerosis of a pathologically altered vein is achieved by introducing catgut sutures into the vein lumen during surgery, which leads to endovasal thrombosis. The disadvantage of this method is the presence in the lumen of the vein of a foreign material containing a foreign protein, which leads to various allergic and inflammatory reactions in the vessel and its surrounding tissues.

 There is a method of treating varicose veins ([2] - analogue) by extraction of the altered veins using special probes with olives. The disadvantages of this method include its invasiveness, accompanied by damage to the paravasally conducting nerve trunks, lymphatic vessels, cliff of varicose inflows. The presence of a large residual cavity (according to our data up to 2-2.5 cm in diameter) with hemo- and lymphorrhea contributes to the occurrence of purulent complications in the postoperative period.

 A known method of surgical treatment of varicose veins ([3] - prototype), aimed at uncoupling the deep and superficial venous systems of the lower limb by occlusion of the mouths of perforating veins flowing into the tibial veins, autogenous. But this method does not lead to obliteration of the already arising varicose superficial veins.

 In addition, these methods are unacceptable in the complicated course of varicose veins: scleroderma, dermatitis, chronic edema, trophic ulcers, thrombophlebitis, in which extraction of the altered vein is either impossible (as a result of a break) or causes severe purulent-necrotic complications.

 The purpose of the invention: improving the quality of surgical treatment of varicose veins of the lower extremities due to a significant reduction in damage to the tissues of blood vessels and nerves, as a result of which the possibility of complications in the postoperative period is reduced and a cosmetic effect is achieved.

 The novelty, theoretical and practical aspect of the development of this method was that occlusion of the affected vein is carried out by introducing autologous veins into it. Therefore, switching off a varicose region of the surface venous system from the bloodstream using material that is not alien to the body does not cause tissue trauma.

 The method is carried out in the following way. During a combined phlebectomy in a patient after extraction of the trunk of a large saphenous vein on the thigh, a section of the last 20-25 cm in length is left in an antiseptic solution.

 If it is necessary to obliterate the site of the altered vein in the area of trophic disturbances proximal and distal to them from a small incision of 1.5-2 cm, a section of the desired vein is allocated into which a thin probe is inserted endovasally to the required length. The autofiled thread fixed to it easily extends inside the blocked vein and reliably blocks the lumen of the vessel throughout. The distal and proximal ends of the autologous veins are fixed with ligatures to the obstructed vein. Wounds are sutured.

 In the postoperative period, local changes in the area of the implanted vein were not observed.

 This method operated on 3 people.

 Example 1. Patient W., 27 years old, was admitted for planned surgical treatment for varicose veins of the lower extremities 3 tbsp. Under anesthesia, a combined phlebectomy was performed on the right with an obstruction of the trunk of a large saphenous vein in the middle and lower third of the leg for 20 cm. The patient was discharged in satisfactory condition for outpatient aftercare 3 days after the operation. Examined after 10 and 30 days. No complaints. Locally: no inflammatory changes were noted.

 Example 2. Patient C. 48 years old, suffering from varicose veins of the left limb 2-3 tbsp., Operated on as planned. A combined left phlebectomy was performed according to the technique adopted in the clinic, including obstruction of the large saphenous vein on the lower leg with a vein fragment from the hip for 25 cm. The postoperative period proceeded smoothly. Sutures were removed on the 8th day. Primary healing. Examined after 1 month from the time of surgery. Functional and cosmetic result is good.

 The proposed method for surgical treatment of varicose veins of the superficial veins of the lower extremities is simple to implement, convenient, less traumatic, cosmetically beneficial, does not require additional equipment.

Literature
1. Toprover G.S. A new method for surgical treatment of varicose veins of the saphenous veins of the lower extremities. Collection of scientific papers of the Stalingrad Medical Institute, 1957, N 11, p. 205-211.

 2. Vedensky A. N. "A method for correcting pathological blood flow in the veins of the lower half of the lower leg." Copyright certificate N 4099265/14 dated 2.08.87.

 3. Komarov I.A. A device with pointed cylinders and removable olives to remove veins. "Clinical Surgery", 1979, N 7, p. 66.

Claims (1)

 A method for surgical treatment of varicose veins of the lower extremities, including occlusion of varicose veins with autovenous trunks, characterized in that the affected vein is occluded in the area of trophic disorders by introducing a portion of the venous trunk with preliminary immersion of the implanted vein section in an antiseptic solution.