Wyniki wyszukiwania - Biblioteka Nauki

1

The Association of Surgery and Sclerotherapy in the Treatment of Severe Chronic Venous Insufficiency

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Woźniak W. , Mlosek K. , Miłek T. , Kowalski M. , Ciostek P.

Polish Journal of Surgery

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2010

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tom 82

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nr 3

159-165

EN

The aim of the study was to evaluate the efficacy of surgery in combination with sclerotherapy in the treatment of severe chronic venous insufficiency.Material and methods. During the period between 2007 and 2009, 38 patients with symptoms of advanced chronic venous insufficiency - C4, C5 and C6, according to the CEAP classification- were subject to surgery in combination with sclerotherapy. The study group comprised 24 (63%) female and 14 (37%) male patients, aged between 42 and 95 years. Twenty-three patients were diagnosed with saphenous vein insufficiency, 14 with small saphenous vein insufficiency, and one with femoro-popliteal venous insufficiency. Based on the VCSS scale, disease symptoms were evaluated before the operation and six months after the surgical intervention. In cases of saphenous or small saphenous vein insufficiency, the patients underwent crossectomy, followed by ligation of the saphenous-femoral and small saphenous-popliteal ostia. The distal segment of the vein was obliterated using a 3% polidocanol foam solution. Control ultrasonography was performed 1, 3, 6 and 12 months after the procedure. Patients with crural ulcerations that did not heal by three months postoperatively were subject to additional epidermal grafts.Results. Statistical analysis of the VSCC point scale before and after the operation demonstrated a significant reduction in the following parameters: pain, presence of varices, edema, ulcerations, and use of compression therapy. Analysis showed an effective elimination of the main venous trunks. Among patients with venous ulcerations, spontaneous healing was observed during the nine months after the procedure was observed in 17 (94%) patients. In one patient, the ulceration was reduced by 30-40%. Neurological, ophthalmological and thromboembolic complications of the deep venous system were not observed.Conclusions. 1. The combination of surgery and sclerotherapy in the treatment of advanced chronic venous insufficiency is a method worthy of recommendation. 2. The method is effective with a low risk of complications, thus significantly shortening hospitalization and absence from work. 3. An evaluation of the disease stage based on the VCSS scale, before and after the operation, demonstrated a significant improvement.

2

Patients with chronic venous insufficiency in the times of COVID-19 and the risk of thrombus formation – suggestions on conservative treatment of such patients based on the principles of pathophysiology

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Krasinski Z. , Krasińska A. , Markiewicz S. , Zieliński M.

Polish Journal of Surgery

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2021

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tom 93

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nr 2

43-52

EN

The current limitations of surgical treatment, as well as restrictions on professional and sport activities related to COVID-19 pandemic require seeking therapeutic solutions for the vast population of patients with chronic venous insufficiency (CVI, chronic venous insufficiency). To understand the principles of pharmacotherapy of this disease, the authors used data related to epidemiology and pathophysiology of CVI. They provided the latest data on venoactive drugs and recommendations that should be followed and summarized the literature based on the EBM. The article should provide the answer to the question of how to deal with patients with varicose veins or, more broadly, chronic venous insufficiency during the pandemic.

3

The Usefulness of Preoperative Doppler Ultrasonographic Evaluation of Saphenofemoral Complex For Improving Lower Limb Varicose Veins Surgery

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Mikusek W. , Arendt J. , Waniczek D. , Rudzki M. , Buda K. , Orkisz W.

Polish Journal of Surgery

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2008

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tom 80

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nr 11

594-603

EN

The aim of the study was to determine whether detailed preoperative Doppler ultrasonographic examination of saphenofemoral complex can improve the results of the lower limb varicose veins surgery.Two groups of patients (30 people each) were operated due to lower limbs primary varicose veins caused by saphenous vein insufficiency. All patients had a routine duplex examination performed. Group B had additional ultrasound examination before the operation to evaluate the number, diameter, and localization of the tributary vessels in the area of saphenofemoral junction. 30 days after the operation, in both groups control duplex examination was performed to evaluate the sparingness of the surgical procedure. The control ultrasonography showed 8 and 2 tributary vessels overlooked in groups A and B, respectively. The differences were statistically significant. The conformity of the preoperative ultrasound and the scene found during the operation in group B was 83.3%. The chance of overlooking peripheral vessels in group A increased 5.1 times.Preoperative Doppler ultrasound estimates localization of tributary vessels within the saphenofemoral junction, which makes detecting vessels during the operation much easier. It allows to minimize the number of technical mistakes and improve the lower limb varicose veins surgery results.

4

A Prospective Comparison of Four Methods of Endovenous Thermal Ablation

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Dzieciuchowicz Ł. , Krasiński Z. , Gabriel M. , Espinosa G.

Polish Journal of Surgery

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2011

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tom 83

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nr 11

597-605

EN

The aim of the study was to compare clinical and duplex Doppler results of treatment of varicose veins with four methods of endovenous thermal ablation (EVTA).Material and methods. The results of treatment of varicose veins with 980 nm laser (EVLA980) in 67 extremities, with a radiofrequency ablation (RFA) in 43 extremities, with 810 nm laser (EVLA810) in 46 extremities and with 1470 nm laser (EVLA1470) in 15 extremities were prospectively analyzed. The data on patients' demographics, weight, stage of the venous disease, type of anesthesia, duration of the procedure, linear energy density (LED) applied, intra- and postoperative complications were collected. Thromboprophylaxis was not routinely administered. The patients were followed clinically and with duplex Doppler for 12 (1-24) months.Results. Technical success was achieved in 99% of limbs. The procedure was carried out under local anesthesia in 140 (91%) of patients. In 17 patients bilateral procedure was performed. There were one gastroenemius muscle vein thrombosis and one protruding thrombus from sapheno-femoral junction in EVLA810. No other serious complications were observed. A median LED was higher in EVLA810 than in EVLA980 and EVLA1470, 86.8 (82-94), 59.2 (45.4-74.4) and 58.8 (53-67.7) J/cm, respectively (p<0.001), though only in EVLA980 was below the intended range. Recanalization rates were 7% after EVLA980, 2% after EVLA810 and 0% after RFA and EVLA1470, p=0.14. The vein shrinking was fastest after EVLA1470. Neither neovascularization nor formation of arteriovenous fistulas was observed. Permanent saphenous nerve paresthesia occurred in two patients after RFA.Conclusions. All methods of ambulatory EVTA are safe and effective once the adequate linear energy density is applied.

5

Great saphenous vein sparing versus stripping in Trendelenburg operation for primary varicose veins: a prospective study

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Kundal A. , Kumar N. , Rajput D. , Chauhan U.

Polish Journal of Surgery

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2021

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tom 93

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nr 1

34-39

EN

Objective: The purpose of this study was to compare the outcome of the great saphenous vein (GSV) sparing versus stripping during Trendelenburg operation for varicose veins. Methods: This was a prospective randomized study of primary varicose vein patients who underwent Trendelenburg operation. Data of patients operated on over a period of 16 months was collected, including: below knee GSV diameter by Duplex Ultrasound and revised venous clinical severity score (rVCSS), calculated preoperatively and postoperatively at 2nd, 4th, and 8th week. Results: A total of 36 patients undergoing Trendelenburg operation were included in the study. Nineteen patients underwent GSV sparing while 17 underwent stripping of GSV till just below the knee after juxtafemoral flush ligation of the great saphenous vein. There was a significant decrease in the below-knee GSV diameter (19% after 2 months) and rVCSS (60.8%) in the sparing group. The stripping group also showed an almost similar decrease in below-knee GSV diameter (19.6% after 2 months) and rVCSS (66.3%). However, no significant difference was found between the two groups in terms of change in GSV diameter (P = 0.467) and rVCSS (P = 0.781). Conclusion: Trendelenburg procedure with sparing of GSV can be done routinely for operative management of varicose veins, where surgery is needed.

6

The use of the VEINES-Qol/Sym questionnaire in patients operated for varicose ve

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Migdalski Ł. , Kuzdak K.

Polish Journal of Surgery

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2015

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tom 87(10)

491-498

EN

Venous insufficiency is a common, chronic disease that affects nearly half of the population in highly developed countries. The vast majority of affected patients suffer from varicose veins (VV). Recently, the priority in medicine has been patient satisfaction with treatment and high quality of life. Therefore, disease-specific questionnaires that measure quality of life have been developed. One of these is VEINES-QOL/Sym with two subscales that assess quality of life and disease symptoms. To date, it has been used to examine patients with venous ulcers and thrombosis. No data are available concerning the use of VEINES to assess patients after VV surgery. The aim of the study was to investigate the change in QOL after VV surgery and verify the usefulness of VEINES in daily phlebological practice. Material and methods. The study recruited 69 patients (CEAP class C2-C3) in need of surgery for VV. The patients responded 2 hours before surgery and after 3 months. Patients were differentiated into several categories according to CEAP stage, age, sex, BMI, the use/lack of compression therapy, and education level. Results. The quality of life increased significantly in C3 patients and in patients over the age of 50. Quality of life increased significantly in all patients regardless of education. There were no differences between groups differentiated according to sex, the use or lack of compression therapy, or BMI. Conclusions. The VEINES-QOL/Sym questionnaire can be used in daily phlebological practice to assess patients before and after surgical treatment of VV. VEINES-QOL/Sym is reliable and highly valid.

7

Kriochirurgia w leczeniu żylaków kończyn dolnych

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Czajkowski K.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2006

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tom Vol. 12, nr 3

195-196

PL

Coraz więcej osób cierpiących na żylaki nóg poszukuje informacji o nowych, alternatywnych metodach leczenia tego schorzenia. Większość pacjentów czerpie wiedzę o terapii od krewnych lub znajomych, którzy byli już leczeni. Zebrane w ten sposób informacje nie zachęcają do podjęcia szybkiej decyzji o operacji, po tradycyjnym zabiegu pozostają bowiem często szpecące blizny.

8

Opieka pielęgniarska nad pacjentem z żylakami kończyn dolnych.

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Cebulski J.

Współczesne Pielęgniarstwo i Ochrona Zdrowia

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2014

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nr 3

77-79

PL

Żylaki kończyn dolnych przez większość osób postrzegane są jako nieestetyczne wypukłości na skórze, które nie mają większego wpływu na zdrowie. Myślenie to jest błędne, ponieważ zmiany te mogą powodować szereg następstw mogących prowadzić nawet do śmierci. Opieka pielęgniarska nad pacjentem z żylakami kończyn dolnych polega na prowadzeniu działań profilaktyczno edukacyjnych. Przekazuje mu się wiedzę dotyczącą samej jednostki chorobowej i wdrożonego leczenia, ale również uczula się go na możliwe do wystąpienia powikłania pooperacyjne, przy jednoczesnym uwzględnieniu jego indywidualnych potrzeb fizycznych i duchowych. Przekazuje mu się wiedzę dotyczącą pielęgnacji operowanej kończyny i dalszej profilaktyki.

EN

Varicose veins are commonly perceived as merely unpleasant-looking swellings on lower extremities which do not pose any significant threat to our state of health. However, in actual fact they can lead to major complications, some of which might be even lethal. The health care provided by a nurse to a patient with varicose veins is focused on the education of patient on the characteristics of the disease and teach him, how to observe any varicose changes in the operated leg. Also his individual physical and spiritual needs have to be taken into account. Moreover, the patient is educated not only on the disease itself as well as the treatment procedures but also on possible post-operative complications which may occur in the future and the ways of preventing them.

9

Standardy badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego – aktualizacja. Badanie żył kończyn dolnych

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Małek G. , Nowicki A.

Journal of Ultrasonography

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2014

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tom 14

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nr 58

287-296

EN

This article has been prepared on the basis of the Ultrasonography Standards of the Polish Ultrasound Society (2011) and updated based on the latest findings and reports. Ultrasound examination of the lower extremity veins is relatively easy and commonly used to confirm or rule out venous thrombosis. However, a relatively easy compression test frequently requires experience, particularly in situations when imaging is difficult (due to lymphedema, dressing or thick tissues). The technique is time-consuming and requires assessment of each deep vein every 1 cm. Lesions in the deep veins cannot be ruled out when the vessels are assessed in only 2–3 points – a full examination is needed. The value of the method is the highest when the proximal section is assessed and the lowest when crural veins are evaluated. Doppler sonography is the basic method used when patients are prepared for a surgery of varicose veins. The assessment of the superficial veins prior to this procedure is tedious and requires knowledge of anatomy together with numerous variants. A considerable challenge is posed by re-assessment of recurrent varicose veins following a previous surgery. The Standards include anatomic nomenclature proposed by the Polish Society for Vascular Surgery and Polish Society of Phlebology, which should facilitate communication with clinicians. The most beneficial patient positions have been thoroughly discussed in terms of safety and effectiveness of the examination. Sometimes during such an examination, no venous pathology is found, but other changes with symptoms that suggest deep thrombophlebitis are detected. In such a situation, it is necessary to conduct an initial (or complete, if possible) assessment of lesions as well as provide recommendations connected with further, more detailed diagnosis.

PL

Pracę przygotowano na podstawie Standardów badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego (2011) i zaktualizowano, opierając się na najnowszych doniesieniach z piśmiennictwa. Badanie ultradźwiękowe żył kończyn dolnych jest metodą względnie prostą i powszechnie stosowaną do rozpoznawania lub wykluczania zakrzepicy żylnej. Z założenia prosta w wykonaniu próba uciskowa bardzo często wymaga dużego doświadczenia, zwłaszcza w sytuacjach utrudniających obrazowanie (obrzęk chłonny, opatrunek czy duża grubość tkanek). Technika badania jest pracochłonna i wymaga oceny każdej żyły głębokiej co 1 cm. Nie można więc wykluczyć zmian w układzie żył głębokich, oceniając naczynia tylko w 2–3 punktach – konieczne jest pełne badanie. Wartość metody jest największa w ocenie żył odcinka proksymalnego, najmniejsza zaś w ocenie żył podudzia. Ultrasonografia dopplerowska stanowi podstawową metodę w przygotowaniu pacjenta do operacji żylaków. Ocena żył powierzchownych przed tym zabiegiem jest żmudna i wymaga znajomości anatomii wraz z licznymi odmianami. Dużym wyzwaniem bywa ocena żylaków nawrotowych, po wykonanej wcześniej operacji. W standardzie uwzględniono mianownictwo anatomiczne zaproponowane przez Polskie Towarzystwo Chirurgii Naczyniowej i Polski Towarzystwo Flebologiczne, co powinno ułatwić komunikację z klinicystami. Szczegółowo omówiono proponowane podczas badania pozycje, najbardziej korzystne ze względu na bezpieczeństwo pacjenta i efektywność wyniku. Wielokrotnie podczas tego badania nie znajduje się patologii żylnej, ale inną, dającą objawy sugerujące zapalenie zakrzepowe żył głębokich. W takiej sytuacji konieczna jest wstępna ocena zmian (lub gdy to możliwe – pełna) i dalsze ukierunkowanie bardziej szczegółowej diagnostyki.

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The psychological aspects of everyday functioning in a group of patients with varicose veins – an assessment with VEINES Qol/Sym for patients before and after varicose veins surgery

63%

Migdalski Ł. , Błaszczyński P.

Psychiatria i Psychologia Kliniczna

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2015

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tom 15

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nr 3

115-121

EN

Psychological functioning of patients in early stages of venous insufficiency has not been a common subject of scientific investigation so far, even though this group of patients experiences many limitations in daily functioning, as well as psychological distress. Varicose veins are the most common type of venous insufficiency, with an epidemiology of up to 50% of the western population. The present study is concerned with the functioning of a group undergoing surgery of varicose veins. The operation was carried out in an ambulatory mode, and such psychological factors as acceptance of illness, anxiety–state, anxiety–trait, and wellbeing (treated as personality construct) have been considered. It is the first time that such variables have been used with the new tool for assessing quality of life in venous diseases (VEINES Qol/Sym), and no previous findings about applying VEINES Qol/Sym to assess patients after varicose veins operations exist. The results are promising, especially for combining such psychological variables as anxiety, acceptance of illness, or wellbeing with specific venous measures of quality of life. It has been proved that there is a need for monitoring psychological variables in the group of patients in an early stage of chronic venous illness. Further research on other venous patient groups is necessary to fully understand the specificity of these groups.

PL

Psychologiczne funkcjonowanie pacjentów we wczesnych stadiach niewydolności żylnej nie było jak dotąd częstym przedmiotem badań, pomimo faktu, że doświadczają oni licznych ograniczeń codziennego funkcjonowania oraz dystresu psychologicznego. Żylaki są najczęstszą formą niewydolności żylnej, zmaga się z nimi nawet 50% populacji zachodniej. Opracowanie dotyczy funkcjonowania pacjentów przed i po zabiegu operacyjnego leczenia żylaków kończyn dolnych. Operację przeprowadzono w trybie ambulatoryjnym, a w badaniu uwzględniono takie zmienne psychologiczne, jak akceptacja choroby, lęk – stan, lęk – cecha, dobrostan (rozumiany jako konstrukt osobowościowy). Po raz pierwszy zestawiono takie zmienne z nowym narzędziem mierzenia jakości życia w chorobach żylnych (VEINES Qol/Sym), nie było też dotychczas danych na temat zastosowania tego narzędzia w grupie pacjentów poddawanych operacyjnemu leczeniu żylaków. Uzyskane wyniki są obiecujące – szczególnie ciekawych wniosków dostarcza zestawienie zmiennych lęku, akceptacji choroby i dobrostanu ze specyficzną miarą jakości życia. Wykazano, że istnieje potrzeba monitorowania zmiennych psychologicznych w grupie osób we wczesnym stadium niewydolności żylnej. Zrozumienie specyfiki problemów żylnych wymaga dalszych badań z udziałem następnych grup pacjentów z tymi problemami.