Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Pomadas/administración & dosificación , Seno Pilonidal/cirugía , Cicatrización de Heridas/efectos de los fármacos , Administración Tópica , Adolescente , Adulto , Alginatos/administración & dosificación , Aloe , Calostro , Femenino , Glicerol/administración & dosificación , Humanos , Ácido Hialurónico/administración & dosificación , Italia , Masculino , Persona de Mediana Edad , Pomadas/química , Periodo Posoperatorio , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVES: To compare the long-term results of stripping vs. haemodynamic correction (Ambulatory Conservative Haemodynamic Management of Varicose Veins, CHIVA) in the treatment of superficial venous incompetence resulting in chronic venous disease (CVD). DESIGN: Randomised comparative trial. PATIENTS: 150 patients affected by CVD, CEAP clinical class 2-6, were randomised to saphenous stripping or to CHIVA. METHODS: The clinical outcome was assessed by an independent observer who recorded the Hobbs clinical score for treated limbs. A subjective report of the outcome was provided by the patients. Recurrence of varices was assessed by both clinical examination and duplex ultrasonography. RESULTS: The mean follow-up was 10 years, 26 patients were lost to follow-up. The Hobbs score similar in the stripping and CHIVA groups. However recurrence of varicose veins was significantly higher in the stripping group (CHIVA 18%; stripping 35%, P<0.04 Fisher's exact test), without significant differences in the rate of recurrences from the sapheno-femoral junction. The associated risk of recurrence at ten years was doubled in the stripping group (OR 2.2, 95% CI 1-5, P=0.04). CONCLUSIONS: Recurrent varices occurred more frequently following saphenous stripping than after CHIVA treatment. The deliberate preservation of the saphenous trunk as a route of venous drainage in the CHIVA group may have been a factor reducing the recurrence rate.
Asunto(s)
Hemodinámica , Várices/cirugía , Procedimientos Quirúrgicos Vasculares , Insuficiencia Venosa/complicaciones , Enfermedad Crónica , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Satisfacción del Paciente , Medición de Riesgo , Prevención Secundaria , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Doppler Dúplex , Várices/diagnóstico por imagen , Várices/etiología , Várices/fisiopatología , Insuficiencia Venosa/diagnóstico por imagen , Insuficiencia Venosa/fisiopatología , Insuficiencia Venosa/cirugíaRESUMEN
BACKGROUND: We frequently observe a tributary of the saphenous vein with the origin in the saphenous compartment of the medial aspect of the upper third of the leg. It runs transversally in the interfascial compartment toward the lateral aspect of the leg. Constantly it feeds by reflux varicose veins clinically visible in the paratibial region and/or in the lateral aspect of the leg. For the peculiarity of its anatomical shape as well as duplex appearance, we defined it as the "T" vein. OBJECTIVES: To assess how frequently the "T" vein of the leg is involved in varicose networks. METHODS: A total of 218 consecutive patients affected by primary varicose veins have been evaluated by the means of duplex scanning. We assessed both the presence of the above-mentioned tributary and the frequency of its hemodynamic involvement in the varicose network. RESULTS: In 15 of 218 cases (7%) we demonstrated the above-mentioned tributary with an interfascial length ranging between 5 and 12 cm involved in varicose networks. CONCLUSIONS: The anterior tributary of the saphenous vein of the anterolateral aspect of the leg is a neglected clinical entity, whose existence is important to know for the treatment of varicose veins of the lateral aspect of the leg.