Efficiency of various methods of surgical treatment of chronic diseases of lower limb veins (analysis of our experience)

Abstract

The article deals with classification issues, the current state of medical and surgical treatment of chronic diseases of the veins of the lower extremities, widely used in world practice, innovative domestic developments based on electrocoagulation and electric welding technologies, as well as their comparative characteristics among themselves and with laser methods based on their own experience. The aim — to compare effectiveness of open and minimally invasive surgical techniques in patients with varicose disease (VD) and post‑thrombotic disease (PTD) of the lower extremities, to assess the possibility of Ukrainian high‑tech developments using. Materials and methods. Analysis was conducted of surgical treatment of 94 patients with VD for the period from 2014 to 2017 and 81 patients with PTD (the period from 2002 to 2010) in the «Olexandrivska» clinical hospital in Kyiv. Results and discussion. The results of treatment were evaluated at 4 weeks, 3 months, and 6 months after surgery by sonographic criteria, the presence of local edema, the dynamics of the trophic changes in soft tissue of the shin. After 1 month, a slight improvement was fixed at 18 % of the patients of the main group, moderate improvement — at 74 %, significant improvement — at 8 %. In 3 months the estimated effectiveness was 2 %, 12 %, 86 %, in 6 months — 2 %, 6 %, 92 %, respectively. The average length of hospital stay for patients in the main group was 2.4 ± 0.4 days, whereas in the control group this indicator was 5.2 ± 1.2 days. Conclusions. Endovenous laser coagulation and subfascial endoscopic dissection are effective, low‑impact methods for treating lower limb varicose and post‑thrombotic diseases of the lower extremity veins and should actively supplant open methods of surgical treatment. Ukrainian developments using high‑frequency electric welding and electrocoagulation technologies could take leading positions in phlebology.