Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2012 Vol. 20 No 1

GENERAL AND SPECIAL SURGERY

S.E. KATORKIN, G.V. YAROVENKO, P.N. MYSHENTSEV, A.A. ZHUKOV, E.S. ISAEVA, D. MOCHAMMAD

EVALUATION OF VARIOUS METHODS OF OPERATIVE CORRECTION OF CHRONIC VENOUS INSUFFICIENCY FROM THE POINT OF EVIDENCE-BASED MEDICINE

SBEE HPE Samara State Medical University,
the Russian Federation

Objectives. To evaluate the results of surgical treatment of patients with chronic venous insufficiency when different types of surgical interventions on the perforating veins are carried out from the standpoint of evidence-based medicine.
Methods. The results of 401 surgical interventions in patients with C3-C6 classes of chronic venous insufficiency are analyzed. To assess effectiveness and objectification of treatment results the method of clinical analysis of motion was used on the hardware-software complex MBN-Biomechanics, including podometry, electromyography, goniometry in the process of walking before and after the surgery. Registration of support reactions, position and motion of general pressure center to the support surface in orthostasis was carried out using dynamometer and stabilometry. Ultrasonic dopplerography was performed on the apparatuses Aloka 4 and Logic 7. The examination was conducted in the nearest (3 months) and distant (up to 3 years) postoperative periods.
Results. Cocketts operation doesnt eliminate the pathological shin muscular-venous pump overloading. Lintons operation disturbs the function of the shin muscular-venous pump in the early postoperative period. Endoscopic dissection of the shin perforating veins is rather radical one and does not disturb the function of the shin muscular-venous pump. Accompanying pathology of the locomotive system worsens the results of operative interventions.
Conclusions. Using the methods of evidence-based medicine permits to evaluate objectively the results and make recommendations when choosing a surgical option in patients with chronic venous insufficiency of the lower limbs.

Keywords: chronic venous insufficiency, surgical correction, evidence-based medicine
p. 46 53 of the original issue
References

1.Kosinets AN, Sushkov SA. Varikoznaia bolezn': ruk dlia vrachei [Varicose veins: a guide for physicians].Vitebsk, RB: VGMU; 2009. 415 p.
2.Uhl J, Gillot C. The foot venous pump: anatomy and physiology. XV World Congress of the Union Internationale de Phlebologie: e-abstract book. Monaco; 2009. 142 p.
3.Simka M. Calf muscle pump impairment and delayed healing of venous leg ulcers: air plethysmographic findings. J Dermatol. 2007;34(8):537544.
4.Partsch H. Varicose veins and chronic venous insufficiency. Vasa. 2009;38(4):293301.
5.Sushkov SA. Osnovnye printsipy operativnogo lecheniia varikoznoi bolezni nizhnikh konechnostei [The main principles of surgical treatment of varicose veins of lower extremities]. Novosti Khirurgii. 2010;(4):12334.
6.Kirienko AI, et al. Otdalennye rezul'taty endoskopicheskoi dissektsii perforantnykh ven goleni pri khronicheskoi venoznoi nedostatochnosti [Long-term results of endoscopic dissection of perforating veins of legs with chronic venous insufficiency]. Angiol i Sosud Khirurg. 2007;(2):6871.
7.Katorkin SE Biomekhanicheskie aspekty khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei [Biomechanical aspects of chronic venous insufficiency of lower extremities]. Saarbrucken, Germany: LAP LAMBERT Academic Publishing; 2011. 414 p.
8.Zhukov BN, Katorkin SE. Innovatsionnye tekhnologii v diagnostike, lechenii i meditsinskoi reabilitatsii bol'nykh khronicheskoi venoznoi nedostatochnost'iu nizhnikh konechnostei [Innovative technologies in the diagnosis, treatment and medical rehabilitation of patients with chronic venous insufficiency of lower extremities]. Samara, RF: Samar otd-nie Litfonda; 2010. 383 p.
9.Kotel'nikov GP, Shpigel' AS. Dokazatel'naia meditsina. Nauchno-obosnovannaia meditsinskaia praktika [Evidence-based medicine. Evidence-based medical practice]. Samara, RF; 2000. 126 p.
10.Glants S. Mediko-biologicheskaia statistika. Per s angl. [Medical and biological statistics]. Moscow, RF: Praktika; 1999. 459 p.

Address for correspondence:
443079, Rossiiskaia Federatsiia, g. Samara, pr. Karla Marksa, 165 b, Kliniki Samarskogo gosudarstvennogo meditsinskogo universiteta klinika i kafedra gospital'noi khirurgii,
e-mail: yarovenko_galina@mail.ru,
Yarovenko Galina Viktorovna
Information about the authors:
Katorkin S.E. Candidate of medical sciences, associate professor of the chair and clinic of hospital surgery of Samara State Medical University.
Yarovenko G.V. Doctor of medical sciences, physician of the cardiac-vascular department of the clinic of the hospital surgery of Samara State Medical University.
Myshentsev P.N. Candidate of medical sciences, associate professor of the chair and clinic of hospital surgery of Samara State Medical University.
Zhukov A.A. Post-graduate student of the hospital surgery chair of Samara State Medical University.
Isaeva E.S. Physician, surgeon of the hospital surgery chair.
Mochammad D. Post-graduate student of the hospital surgery chair of Samara State Medical University.
Contacts | ©Vitebsk State Medical University, 2007