Open office-based phlebology of primary chronic vein disease of lower extremities
DOI:
https://doi.org/10.11603/2414-4533.2021.3.12545Keywords:
primary chronic venous disease, CHIVA, office-based surgeryAbstract
The aim of the work: to evaluate the effectiveness of the CHIVA technique in the correction of venous insufficiency of varying degrees in an outpatient setting.
Materials and мethods. The results of open surgical treatment of 578 patients (21.45 % – men and 78.55 % – women) with primary chronic vein disease of the lower extremities were analyzed. There were two groups of patients who underwent planned interventions of 423 (71.18%) patients – group 1 and 155 (26.82 %) patients in an urgent order – group 2. The distribution of patients by severity of primary chronic vein disease was performed according to the classification of CEAP (2020): C2s- – 355 (61.42 %), C3s – 159 (27.51 %), C4s – 38 (6.57 %), C5s – 16 (2.77 %), C6s – 10 (1.73 %). In the structure of group 2, acute thrombophlebitis of the subcutaneous veins of the lower extremities was diagnosed in 143 (92.25 %), bleeding from varicose veins – 12 (7.74 %). The varicose anamnesis of the operated made from 3 to 25 years (on the average (10.4±5.8) years). Bilateral pathology was found in 37.50 % of people, in 62.50 % – unilateral, mainly on the left lower extremity. The degree of clinical manifestations of the disease before and after surgery was assessed using scales (VCSS, VDS, VSS).
Results and Discussion. A comparative analysis of the results of surgical treatment of two groups (emergency and planned treatment) with primary chronic venous disease of the lower extremities in the dynamics of the CHIVA method on the principles of “office-based surgery” showed that the VSDS criterion was normalized in both groups. Among those operated on as planned, this figure was 89.90 % in the early postoperative period. After emergency surgery, 78.30 % of patients recovered somewhat more slowly with its normalization in the late postoperative period. According to the VDS criterion, among those operated on in a planned manner, the recovery process was faster (96.40 %) in the early postoperative period, and full recovery within 3 weeks was found in 89.70 % of operated patients. According to the VSDS criterion, pathological venous reflux in the subcutaneous vein system in the early and late postoperative periods was not diagnosed in any case.
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