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Surgical Treatment in Lower Extremity Varicose Veins

Year 2009, Volume: 14 Issue: 4, 260 - 263, 01.08.2009

Abstract

Objective: The purpose of this study is to evaluate the results of the surgical therapy in patients with chronic venous disease. Materials and Methods: One hundred consecutive patients (133 extremities) who underwent primary varicose vein surgery between January 2000 and January 2007 were included in this retrospective study. The patients were evaluated by clinical examination, including CEAP classification (clinical, etiology, anatomical, and pathological), duplex ultrasonography and phlebography employed after inconclusive duplex results. Results: Of the 100 patients, 66 (66%) were male and 34 (34%) female. The patients' mean age was 34.79 (ranged between 18 and 79). CEAP scores were C2 (52.1 %), C2,3 (25.7%), C2,4 (7.1%), C2,5 (10.7%) and C5 (4.3%). The most frequent symptoms were pain, edema and cramp. The high ligation with stripping was the most commonly applied method (57.1 %). Open subfacial perforator ligation was performed to 21 extremities (15%) additionally. The incidence of sensory impairment was 13.6% and recurrence rate was 5.2 %. Conclusion: The surgical planning of venous incompetence should based on accurate preoperative assesment by duplex ultrasonography or venography and individualized treatment according to different reflux patterns.

References

  • Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg 1999; 29:589-592.
  • Jones L, Braithwaite BD, Selwyn D, et al. Neovascularisation is the principal cause of varicose vein recurrence: Results of a randomised of stripping the long saphenous vein. Eur J Vasc Endovasc Surg 1996; 12:442-445.
  • Papadakis K, Christodoulou C, Christopoulos D, et al. Number and anatomical distribution of incompetent thigh perforating veins. Br J Surg 1989; 76:581-584.
  • Fischer R, Chandler JG, De Maeseneer M, et al. The unresolved problem of recurrent saphenofemoral reflux. Am Coll Surg 2002; 195:80-94.
  • Iafrati MD, Pare GJ, O’Donnell TF, Estes J. Is the nihilistic approach to surgical reduction of superfacial and perforator vein incompetence for venous ulser justified? J Vasc surg 2002; 36:1167-1174.
  • Stuart WP, Adam DJ, Allan PL, et al. Saphenous surgery does not correct perforator incompetence in the presence of deep venous reflux. J Vasc Surg 1998; 28:834-838.
  • Ciostek P, Michalak J, Noszczyk W. Improvement in deep vein haemodynamics following surgery for varicose veins. Eur J Vasc Endovasc Surg 2004; 28:473-478.
  • Padberg FT , Pappas PJ, Araki CT, et al. 2nd: Hemodynamic and clinical improvement after superficial vein ablation in primary combined venous insufficiency with ulceration. J Vasc Surg 1996; 24:711-718.
  • Akagi D,Arita H,Komiyama T,et al. Objective Assessment of Nerve Injury after GreaterSaphenous Vein Stripping. Eur J Vasc Endovasc Surg 2007; 33:625-630.
  • Ramasastry SS, Dick GO, Futrell JW: Anatomy of the saphenous nerve: relevance to saphenous vein stripping. Am Surg 1987; 53:274-277.
  • Morrison C, Dalsing MC: Signs and symptoms of saphenous nevre injury after greater saphenous vein stripping: prevalence, severity, and relevance for modern practice. J Vasc Surg 2003; 38:886-890.
  • Kabul Tarihi: 04.09.2009

Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi

Year 2009, Volume: 14 Issue: 4, 260 - 263, 01.08.2009

Abstract

Amaç: Bu çalışmanın amacı kronik venöz yetmezlikli hastalarda cerrahi tedavinin sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Ocak 2000 ile Ocak 2007 tarihleri arasında primer variköz ven cerrahisi uygulanan ardışık 100 hasta bu retrospektif çalışmaya alındı. Bu hastalar CEAP (klinik, etyolojik, anatomik ve patolojik) sınıflamasını da içeren klinik muayene, duplex ultarson ve bazı durumlarda venografik olarak değerlendirildi. Bulgular: Yüz hastanın 66'i erkek (%66), 34'ü kadın, yaş ortalaması ise 34.79 (18-79) idi. Hastaların CEAP skorları C2 (%52.1), C2,3 (25.7), C2,4 (%7.1), C2,5 (%10.7) ve C5 (%4.3) bulundu. En sık gözlenen semptomlar ağrı, şişlik ve kramptı. Stripingle birlikte yüksek ven ligasyonuen sık kullanılan yöntemdi (%57.1). Açık subfasiyal perfaratör ligasyonu 21 ekstremitede (%15) ilave olarak uygulandı. Çalışmamızda duyu kaybı insidansı 13.6 ve nüks oranı %5.2'dir. Sonuç: Venöz yetmezliğin cerrahi planlanması preoperatif olarak duplex ultrason yada venografiyle tam değerlendirmeye dayanmalı ve tedavi farklı reflü paternlerine göre kişiye özgü olarak belirlenmelidir.

References

  • Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg 1999; 29:589-592.
  • Jones L, Braithwaite BD, Selwyn D, et al. Neovascularisation is the principal cause of varicose vein recurrence: Results of a randomised of stripping the long saphenous vein. Eur J Vasc Endovasc Surg 1996; 12:442-445.
  • Papadakis K, Christodoulou C, Christopoulos D, et al. Number and anatomical distribution of incompetent thigh perforating veins. Br J Surg 1989; 76:581-584.
  • Fischer R, Chandler JG, De Maeseneer M, et al. The unresolved problem of recurrent saphenofemoral reflux. Am Coll Surg 2002; 195:80-94.
  • Iafrati MD, Pare GJ, O’Donnell TF, Estes J. Is the nihilistic approach to surgical reduction of superfacial and perforator vein incompetence for venous ulser justified? J Vasc surg 2002; 36:1167-1174.
  • Stuart WP, Adam DJ, Allan PL, et al. Saphenous surgery does not correct perforator incompetence in the presence of deep venous reflux. J Vasc Surg 1998; 28:834-838.
  • Ciostek P, Michalak J, Noszczyk W. Improvement in deep vein haemodynamics following surgery for varicose veins. Eur J Vasc Endovasc Surg 2004; 28:473-478.
  • Padberg FT , Pappas PJ, Araki CT, et al. 2nd: Hemodynamic and clinical improvement after superficial vein ablation in primary combined venous insufficiency with ulceration. J Vasc Surg 1996; 24:711-718.
  • Akagi D,Arita H,Komiyama T,et al. Objective Assessment of Nerve Injury after GreaterSaphenous Vein Stripping. Eur J Vasc Endovasc Surg 2007; 33:625-630.
  • Ramasastry SS, Dick GO, Futrell JW: Anatomy of the saphenous nerve: relevance to saphenous vein stripping. Am Surg 1987; 53:274-277.
  • Morrison C, Dalsing MC: Signs and symptoms of saphenous nevre injury after greater saphenous vein stripping: prevalence, severity, and relevance for modern practice. J Vasc Surg 2003; 38:886-890.
  • Kabul Tarihi: 04.09.2009
There are 12 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ali Rahman This is me

Kadir Kaan Özsin This is me

Ayhan Uysal This is me

Publication Date August 1, 2009
Published in Issue Year 2009 Volume: 14 Issue: 4

Cite

APA Rahman, A., Özsin, K. K., & Uysal, A. (2009). Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi. Fırat Tıp Dergisi, 14(4), 260-263.
AMA Rahman A, Özsin KK, Uysal A. Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi. Fırat Tıp Dergisi. August 2009;14(4):260-263.
Chicago Rahman, Ali, Kadir Kaan Özsin, and Ayhan Uysal. “Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi”. Fırat Tıp Dergisi 14, no. 4 (August 2009): 260-63.
EndNote Rahman A, Özsin KK, Uysal A (August 1, 2009) Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi. Fırat Tıp Dergisi 14 4 260–263.
IEEE A. Rahman, K. K. Özsin, and A. Uysal, “Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi”, Fırat Tıp Dergisi, vol. 14, no. 4, pp. 260–263, 2009.
ISNAD Rahman, Ali et al. “Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi”. Fırat Tıp Dergisi 14/4 (August 2009), 260-263.
JAMA Rahman A, Özsin KK, Uysal A. Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi. Fırat Tıp Dergisi. 2009;14:260–263.
MLA Rahman, Ali et al. “Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi”. Fırat Tıp Dergisi, vol. 14, no. 4, 2009, pp. 260-3.
Vancouver Rahman A, Özsin KK, Uysal A. Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi. Fırat Tıp Dergisi. 2009;14(4):260-3.