SU912153A1

SU912153A1 - Method of recovery of venous blood flow at damage of proximal part of common femoral or iliac vein

Info

Publication number: SU912153A1
Application number: SU802961280A
Authority: SU
Inventors: Николай Владимирович Проценко; Владимир Константинович Миначенко
Original assignee: Ярославский государственный медицинский институт
Priority date: 1980-07-25
Filing date: 1980-07-25
Publication date: 1982-03-15

Description

Изобретение относитс к медицине, а именно к хирургии кровеносных сосудов.This invention relates to medicine, namely to surgery of blood vessels.

Известен способ восстановлени венозного кровотока при повреждени х проксимального отдела общей бедренной или подвздошной вены, который осуществл етс путем восстановлени целостности магистрального сосуда сегментом поверхностной вены 1 .A known method of restoring venous blood flow in injuries of the proximal common femoral or iliac vein, which is carried out by restoring the integrity of the main vessel with a segment of the superficial vein 1.

Однако известный способ не обеспечивает полного соответстви диаметров трансплантата и поврежденной вены, что приводит к дополнительной операционной травме и расщирению объема оперативного вмешательства. Кроме того, трансплантат после его получени оказываетс полностью лишенным кровоснабжени и иннервации. Полное разобщение сосудисто-нервных св зей аутовены с ткан - ми сосудистого ложа может быть причиной дегенеративных и рубцовых изменений в ее стенке вследствие медленного прорастани сосудов и нервов. Необходимость дополнительной мобилизации бедренной вены и наложение двух сосудистых швов при аутовечознон пластике приводит к удлинению оперативною вмешательства.However, the known method does not ensure full compliance with the graft diameters and the damaged vein, which leads to additional operative trauma and expansion of the surgical intervention. In addition, the transplant after its receipt is completely deprived of blood supply and innervation. The complete dissociation of neurovascular connections of autovenes with the tissues of the vascular bed may cause degenerative and cicatricial changes in its wall due to slow germination of vessels and nerves. The need for additional mobilization of the femoral vein and the imposition of two vascular sutures in case of autovevel plastic surgery leads to a lengthening of surgical intervention.

Целью изобретени вл етс сохранение сосудисто-нервных св зен аутовенозного трансплантата и максимального соответстви диаметров трансплантата и поврежденной вены.The aim of the invention is to preserve the neurovascular connections of the autovenous graft and maximum correspondence of the graft diameters and the damaged vein.

Указанна цель достигаетс тем, что при осуществлении способа восстановлени венозного кровотока при повреждени х проксимального отдела общей бедренной или подвздошной вены путем восстановлени целостности магистрального сосуда сегментом поверхностной вены, пересекают дистальные усть глубокой вены, бедра, поверхностную бедренную вену, далее проксимальный отдел ее перемещают краниально и сшивают с поврежденной веной вьщ1е места повреждени по типу конец-в-конец, а дистальный отдел перев зывают или вщивают в ствол глубокой вены. бедра по типу конец в бок.This goal is achieved by the fact that, in carrying out the method of restoring venous blood flow in injuries of the proximal common femoral or iliac vein by restoring the integrity of the main vessel, the superficial vein segment crosses the distal estuary of the deep vein, thigh, superficial femoral vein, then its proximal part moves the cranial and end-to-end damage to the injured vein is stitched, and the distal section is bound or injected into the trunk of the deep vein . thigh end to side.

Способ осуи1ествл ют следующим образом.The method is described as follows.

Claims

After estimating the magnitude of the defect in the common femoral yen in the wound zone under its plowing link, the superficial femoral vein is released, followed by its intersection at a distance equal to the distance from this mouth to the upper edge of the damaged vessel. The common femoral vein above the mouth of the deep vein of the thigh is cut and tied. Due to the fact that a venous valve is found in the superficial femoral vein below the confluence of the deep femoral vein in approximately 90 cases, the latter after the vessel is reversed and excised. This stage is very important because an imperfect valve can be an obstacle to venous blood flow. After that, the proximal part of the intersected surface of the femoral vein is moved in the cranial direction and sewn into the common femoral or external iliac vein above the zone of damage to the vessel, such as end to end. The distal section of the superficial superficial femoral vein is tied up or sewn into the side of the end into the trunk of the deep vein of the thigh. This method ensures that the diameters of the graft and the receptive vessel match, does not require additional time for taking subcutaneous veins for autotransplantation, and therefore reduces the volume and trauma of surgical intervention. Correspondence of the diameters of the compared veins excludes the possibility of turbulent blood flow and, thus, prevents thrombosis in the reconstruction zone. The need for a plastic vein of the entire ONE vascular suture reduces the duration of this phase of the operation. The intersection of the superficial femoral vein at only one level leads to the preservation of innervation and blood supply in the displaced vein due to the vessels and nerves of the adventitia. This prevents the development of degenerative-dystrophic changes in the venous wall, ensuring its viability. Claims of the method of restoring venous blood flow in injuries of the proximal common femoral or iliac vein by restoring the integrity of the main vessel with a segment of the surface vein, characterized in that, in order to preserve the neurovascular connections of the autovenous graft and the maximum correspondence of the graft diameters and lesions to the autovenous graft and the maximum corresponding graft diameters and lesions. they cross the distal estuary of the deep vein of the thigh, the superficial femoral vein, then the proximal part is moved cranially and sutured t with the damaged vein above the injury type end to end, and the distal ligated or sewn into the barrel deep femoral vein type end to side. Sources of information taken into account during the examination 1. V. K. Minachenko. Features of surgical treatment of combined injuries of the bone and vessels of the extremities. - In the book. Osteosynthesis of titanium rods, Yaroslavl, 1979, p. 91-103.