SU1560110A1 - Method of surgical treating of postthrombophlebitic syndrom of pelvis and lower extremities - Google Patents

Abstract

This invention relates to surgery and can be used in the treatment of post-thrombophlebitic syndrome of the pelvis and lower extremities. The purpose of the invention is to reduce trauma by using the recanalized vein of the affected lower limb. For this, in the upper third of the thigh of the healthy lower limb, a segment of the great saphenous vein with a preserved valve is located to the place where it falls into the common femoral vein. From individual incisions on the medial surface of the thigh of the affected lower extremity, the recanalized superficial femoral vein is separated up to merge with the deep femoral vein. In this place the superficial femoral vein is crossed. The distal end of the vein is sutured, and the proximal is conducted in the suprapubic tunnel to the opposite side and anastomose with a large saphenous vein of the healthy side of the "end to side" type. The method reduces the invasiveness of the operation by using the recanalized vein of the affected limb.

Description

The invention relates to surgery and can be used for the treatment of post-troboflebitic syndrome of the pelvis and lower extremities.

The purpose of the invention is to reduce trauma by using the recanalized vein of the affected lower limb.

The method is carried out as follows.

Oblique-longitudinal access is made in the upper third of the thigh of the healthy lower extremity, the segment of the great saphenous vein with the valve retained is reached to the point where it falls into the common femoral vein. From individual incisions along the medial surface of the thigh of the affected lower extremity, the recanalized superficial femoral vein is separated up to merge with the deep femoral vein. In this place the superficial femoral vein is crossed. The distal end of the vein is sutured, and the proximal end is conducted in the suprapubic tunnel to the opposite side and anastomized with a large saphenous vein of the healthy side of the type “end to end” Example. B. P., 51 g. Diagnosis: Post-thrombophlebitic syndrome of the right lower extremity, edematous-pain form. Occlusion of the ileo-femoral segment on the right, recanalization of the superficial femoral vein. The diagnosis was confirmed by phlebography. From the oblique-longitudinal access to the B / 3 of the left femur, a segment of the large saphenous vein is up to 10 cm long. The large saphenous vein with a diameter of 6.3 mm of the trunk type with full valves. Venous branches flowing into the great saphenous vein are clamped and ligated. From two longitudinal cuts on the right thigh, a recanalized superficial hip vein with a diameter of

O1

about

6.5 mm trunk type. The measurement of the venous pressure gradient in the common femoral veins was performed using the MT-33 apparatus, which reaches 0.65 kPa. The reestablished superficial femur Vienna right lower limb at the level of n / 3 right thigh above the anastomosis with the deep femoral vein is cut off and brought out into the wound in the suprapubic region through a tunnel. Its distal end is sutured with an atraumatic thread 6-0. The distance from the proximal end of the recanalized superficial femoral vein of the right lower extremity, bred to the wound in the suprapubic area, to the common femoral left lower limb, which was 6.0 cm, was measured. The large saphenous vein of the left lower extremity at a distance of 7 cm was clamped, clipped, its distal end is ligated. The proximal end through the tunnel is put into the wound above the pubis. The anastomosable surfaces of the great saphenous vein of the left and superficial femoral veins of the right lower extremities were cut off at an angle of 45 °. Atraumatic thread 6–0 anastomosis of the type “end to end” was created using a precision technique. After removing the clips, the anastomosis is sealed; a satisfactory filling of the shunt with blood is determined. Considering that the gradient is veno0

pressure reached 0.65 kPa, the operation was supplemented by the imposition of a temporary arterio-venous junction between the branch of the great saphenous vein and the superficial femur

arteries. In the postoperative period, the patient received anticoagulants of direct and indirect action. The wounds healed by primary tension. The swelling of the right lower extremity has disappeared, there is no pain. The operation of the shunt is verified by echolocation data. On day 14, he was discharged in satisfactory condition.

The proposed method operated on 6 patients with positive results. This method is recommended for the treatment of

postthrombophlebitic syndrome of the pelvis and lower extremities.

Claims (1)

Invention Formula A method of surgical treatment of post-thrombophlebitic syndrome of the pelvis and lower 0 limbs, including the creation of a reinforced suprapubic shunt, characterized in that, in order to reduce trauma by using a recanalized vein of the affected lower limb, the 5th superior vein of the thigh is crossed in the proximal section, reversed and anastomized with the large subcutaneous vein of the healthy limb.