Authors
Botashev R.N.
Karachay-Cherkess Republican Clinical Hospital, Cherkessk
Abstract
Thrombosis of the superficial veins of the lower extremities (thrombophlebitis) is a common pathology, especially in patients with varicose veins. Various methods from anticoagulant therapy to surgical intervention have been proposed and used to treat such patients, but there are still controversial points about their choice.
Aim: to compare the results of surgical treatment of patients with ascending varicothrombophlebitis of the main subcutaneous veins of the lower extremities by radiofrequency ablation and crossectomy.
Materials and methods. The study included the results of treatment of 24 patients (6 (25%) men and 18 (75%) women, the average age of patients was 54±15 years) with varicose veins of the lower extremities class C2-C5 (according to CEAP) and thrombosis of the great saphenous vein and its tributaries. Group I — patients after radiofrequency ablation (n = 12), group II — patients after crossectomy (n = 12). In the postoperative period, the clinical condition and quality of life were assessed according to the CIVIQ-2 questionnaire, control ultrasound examinations were performed 1, 3, 7, 14 days, 1 month and 1 year after surgery.
Results. In the postoperative period, no recurrence of the disease was detected in any of the groups, p>0.005. Lymphorrhea was noted in group II in 16.6% of cases (n = 2), in I this complication was not detected. p<0.005 Parasthesia in patients of group I was detected in 8.3% of cases (n = 1), in Group II in 25% of observations (n = 3), p<0.005. Indicators of the pain factor according to the CIVIQ-2 questionnaire in group I: 1.73±0.93, in group II: 2.8±1.05, p<0.005. In group I, the average bed day was 1.4±0.2 and the duration of disability was 4.9±0.2, in group II — 6.1±1.3 and 13±1.2, respectively (p<0.005).
Conclusion. Surgical methods of treatment of patients with varicose veins of the lower extremities complicated by ascending thrombophlebitis are effective and safe in terms of prevention of venous thrombembolism. Endovenous radiofrequency ablation, being a less traumatic method, avoids general anesthesia, significant cosmetic defects, the development of lymphorrhea, paraesthesia and other complications, especially in obese patients, as well as reduces the time of hospitalization and postoperative rehabilitation.
Keywords: varicose veins, thrombophlebitis, radiofrequency ablation, surgical treatment.
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