Journal «Angiology and Vascular Surgery» • 

2000 • VOLUME 6 • №4

THE ROLE OF ENDOSCOPIC DISSECTION OF PERFORATING VEINS IN PATIENTS WITH CHRONIC VENOUS INSUFFICIENCY AND TROPHIC DISTURBANCES

V.V. Kungurtsev, V.R. Chizh, I.M. Goldina

Endoscopic revision ofsubfasdal space and dissection of crus perforating veins was analysed in 41 patients with decompensation stage of venous insufficiency. All patients demonstrated skin hyperpigmentation in lower third of crus, 20 – a history of trophic ulcer, 9 patients had active trophic ulcer. All patients underwent combined surgical interventions in superficial veins and endoscopic dissection of incompetent leg perforating veins. Subfascial dissection was performed by Richard Wolf instrumentation set. Intraoperative complications were observed in 2 patients: bleeding of dissected perforating vein was stopped by external manual compression in its projection. Early postoperative complications included 1 case of superficial purulence, 2 cases of paresthesia of leg internal side causedby subcutaneous nerve injury. Mean length of hospital stay was 5.5 days. The timing of ulcer epitheliwtion depended from its size, longevity and manifested induration of surrounding tissues. Thus endoscopic dissection of perforating veins (EDPV) appeared to be a radical and minimally invasive procedure/or elimination of perforating vein insufficiency, that allowed to preserve the integrity of leg fascial sheath, to decrease the rate of postoperative complications and length of hospital stay, and thus treatment costs. EDPV helps to achieve good clinical and cosmetic effects and improve patient's life quality.

KEY WORDS: varicose veins, perforating veins, trophic ulcer.

P. 47

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