Stripping lung versus stripping safenian scurt în rata recidivei maladiei venoase cronice primare

Abstract

Introducere. Patogenia maladiei varicoase prevede refluxul vertical prin joncţiunea safeno-femurală, principiu la baza căruia a stat intervenţia chirurgicală elaborată de către F. Trendelenburg (1890), iar C.H. Mayo (1906) şi W. G. Babcock (1907) au elaborat tehnica şi instrumentarul pentru strippingul trunchiului venos. Scopul. Analiza rezultatelor tratamentului chirurgical al maladiei venoase cronice primare în urma efectuării strippingu-lui safenian lung versus stripping safenian scurt. Material şi metode. S-a efectuat analiza retrospectivă a datelor clinice (anamneza, statusul vascular local), protocoalele operaţiei şi a ultrasonografiei duplex la pacienţii operaţi pentru boala varicoasă în secţia chirurgie IMSP SCM nr.1 municipiul Chişinău în cadrul Catedrei Chirurgie Generală şi Semiologie a USMF “Nicolae Testemiţanu” pe parcursul anilor 2000-2007. În studiu au fost incluse 110 persoane (157 extremităţi). Timpul examinării pacienţilor de la momentul operaţiei a constituit minim 5 ani. Rezultate. Stripping safenian lung a fost efectuat pe 95 (60,5%)membre, iar în restul cazurilor stripping safenian scurt 62(39,5%). Persoanele cu clasa funcţională Co şi C1 conform clasificaţiei CEAP, la care nu sunt semne clinice de maladie varicoasă (varice ale membrelor inferioare ≤ 3 mm) constituie 71,58% la care s-a efectuat stripping safenian lung şi 69,36% la care s-a efectuat stripping safenian scurt. Scor general conform chestionarului VCSS (Venous Clinical Severity Score) la persoanele operate prin stripping safenian lung a constituit 2,06±0,34 versus 2,59±0,58 la cei operaţi prin stripping safenian scurt. Concluzii. Rezultatele preliminare a studiului au stabilit că recidiva postoperatorie la persoane ce au suportat stripping safenian lung este de 28,42%, iar recidiva în cazul stippingului safenian scurt constituie 30,64%.

Introduction. Pathogenesis of varicose disease provides vertically reflux through sapheno-femoral junction, the principle according to which was developed the surgical intervention by F. Trendelenburg (1890) and C.H. Mayo(1906) and W. G. Babcock (1907) who developed also techniques and tools for stripping the vein trunk. The aim. The analyses of the surgical treatment’s of primary chronic venous disease after performing the stripping of long versus short saphenous. Material and methods. It was performed a retrospective analysis of clinical data (anamnesis, local vascular status) the surgery and doppler ultrasound protocols of patients operated for varicose disease in the department of surgery of IMSP SCM Nr.1 Chisinau in the The Clinic of General Surgery and Semiology State University of Medicine and Pharmacy "Nicolae Testemiţanu", during 2000-2007 years. In the study was included 110 persons (157 limbs). The patient’s examination period from the beginning of the surgery consists at least 5 years. Results. Long saphenous stripping was performed on 95 (60.5%) limbs on the rest of the cases was performed the short saphenous 62 (39.5%). The persons with functional class C0 and C1 according to CEAP classification, which have not clinical signs of varicose disease veins (varicose veins of the lower limbs ≤ 3 mm) represents 71.58% which underwent long saphenous stripping and on 69.36% short saphenous stripping. Overall score according to the VCSS questionnaire (Venous Clinical Severity Score) at the persons operated by long saphenous stripping consist in 2,06±0,34 versus 2,59±0,58 operated by short saphenous stripping. Conclusions. Preliminary results of the study proved that postoperative recurrence at the patients who have undergone long saphenous stripping is 28,42% and the recurrence in short saphenous striping is 30,64%.