Medicinski vjesnik, Vol. 21 No. (1-2), 1989.
Stručni rad
Comparative values of supra and subfascial approaches to insufficient preforant veins of the lower leg
Mladen Ivanković
Sažetak
The author’s own conclusions are based on the results of retrospective and prospective clinical studies as well as on the investigations of the long-term results of the operative treatment. The retrospective study comprises the analysis of 106 patients treated operatively for the insufficiency of perforant veins in the period from 1st January, 1980 to 31st December, 1984. The prospective study comprises the analysis of 29 patients treated operatively in the period from 1st January, 1985 to 31st December, 1985. In both studies immediate complications were followed-up as well as the results of the treatment by supra and subfascial approaches to the insufficient perforant vein of the lower leg. In January 1987 the investigation of the long-term results was performed in 91 patients, which is 67.4% of all operations. The results of the collected data range between 2 and 7 years. The total number of immediate complications is 17.7%, the least being with Edwards’ subfascial approach (4.8%). Regardless of the operative approach on insufficient perforant veins, significant results are always achieved, i.e. over 50% of patients are cured. Somewhat better results are achieved with the subfascial approach, as compared to the suprafascial, but Edwards’ approach seems to be the best (91% of patients with perforant vein insufficiency and varices and 88.8% of patients with perforant vein insufficiency, varices and ulcus completely cured). Long-term postoperative results are also better with subfascial approaches, especially with Edwards’ method combined with striping of the insufficient superficial veins and extirpation of varices (43.7% of cases cured and 56.3% improved). The application of different operative methods points to the fact that in the treatment of insufficient perforant veins and vein hypertension the best approach is still looked for. The comparison of immediate and long-term results of supra and subfascial methods gives advantage to the subfascial method, especially Edwards’ approach. More and more often, systematic operations according to Linton and Cockett give way to single supra or subfascial resections (ligation and dissection) of insufficient perforant veins.
Ključne riječi
leg; postoperative complications; varicose veins; varicose ulcer; venous insufficiency
Hrčak ID:
196768
URI
Datum izdavanja:
1.12.1989.
Posjeta: 811 *