Surgical Treatment in Lower Extremity Varicose Veins

Öz

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.

Anahtar Kelimeler

• -

Alt Ekstremite Variköz Venlerinde Cerrahi Tedavi

Öz

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.

Anahtar Kelimeler

• Variköz ven, cerrahi teknik, nüks

Kaynakça

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12. Kabul Tarihi: 04.09.2009