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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. Cockett’s operation doesn’t eliminate the pathological shin muscular-venous pump overloading. Linton’s 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.
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443079, Rossiiskaia Federatsiia, g. Samara, pr. Karla Marksa, 165 «b», Kliniki Samarskogo gosudarstvennogo meditsinskogo universiteta klinika i kafedra gospital'noi khirurgii,
Yarovenko Galina Viktorovna
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”.