Journal «Angiology and Vascular Surgery» • 

2008 • VOLUME 14 • №2

ENDOSCOPIC DISSECTION OF PERFORATING VEINS: SURGICAL AND PHARAMACOECONOMIC ASPECTS

Sotnichenko B.A., Makarov V.I., Kalinin A.V., Fefelov E.A., Stepura A.P., Di A.P.
Vladivostok State Medical University,
Vladivostok, Russia

Analysed herein are the outcomes of endoscopic dissection of perforating veins (EDPV) in a total of 113 patients presenting with chronic venous insufficiency (CVI). Of these, 71 patients suffered from varicose disease (VD) and 42 subjects had postthrombophlebic disease (PTPD). 54.9% of the patients were in CEAP class C5-6. All of them underwent EDPV combined with simultaneous phlebectomy or crossectomy. The control group consisted of 26 patients who endured the classic operation by the Linton technique. All those engaged underwent ultrasonographic angioscanning, with part of them being subjected to distal phlebography.

Postoperative complications were observed in 2.65% of the Study Group patients subjected to the EDPV procedure combined with phlebectomy, and in 34.5% of those who had endured the Linton's operation. Both subjective and clinical assessment of surgical outcomes made it possible to define the obtained results as good in 82.3% of cases, as fair in 14.16%, and in four patients with PTPD, the results were defined as poor. The hospital stay following surgery in the Study Group patients amounted to 7.3±0.54 bed days, while in those of the Comparison Group it was 21.2±0.74 bed days.

The obtained findings make it possible to conclude that the scope of surgical interventions in patients presenting with CEAP class C46 CVIs should in the majority of cases amount to simultaneous EDPV and radical venectomy. Such policy reduces the duration of the hospital stay 2.7fold, with a 1.76fold decrease in the treatment costs.

KEY WORDS: perforating veins, chronic venous insufficiency, endoscopic dissection, phlebectomy.

P. 89

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