Novosti
Khirurgii
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Year 2020 Vol. 28 No 1

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

DOI: https://dx.doi.org/10.18484/2305-0047.2020.1.38   |  

A.YU. KRYLOV, .. SHULUTKO, S.E. KHMYROVA, E.G. OSMANOV, .. PETROVSKAYA

OPPORTUNITIES OF EVLA IN COMPLEX TREATMENT OF VENOUS TROPHIC ULCERS IN AGED AND SENILE PATIENTS

I.M. Sechenov First Moscow State Medical Universit, Moscow,
The Russian Federation

Objective. To optimize the results of complex treatment of decompensated forms of varicose disease of the lower limbs in aged and senile patients.
Methods. The complex treatment results of 15 aged and senile patients with venous trophic ulcers of the lower limbs (clinical class C6 according to CEAP) using stem endovenous laser ablation are analyzed. The mean age of the patients was 74.14.76 years (Mσ). All patients had an open trophic leg ulcer, which existed from 10 to 18 years. Endovenous laser ablation was performed using Lakhta-Milon laser apparatus with a wavelength of 1470 nm. In the postoperative period, prophylactic doses of low molecular weight heparins were prescribed as prophylaxis of the venous thromboembolic complications for 5 days. The results were evaluated the next day, one week and one month after the operation. The state of the operated limb and the quality of venous trunk obliteration and the local status of the venous trophic ulcer were evaluated.
Results. All patients were operated on without complications; at the same day they were discharged for outpatient monitoring. A week after the surgery, 8 patients (53.3%) noted a decrease in heaviness and feeling of swelling in the legs, and a month later, 10 patients (66.7%). Positive dynamics of the local status of trophic ulcers was noted in all patients one week after surgery. Complete healing of the trophic ulcer was revealed in 2 patients a week later, in 14 patients (93.3%) by the end of the first month after surgery, in one patient complete healing of the trophic ulcer was detected by the end of the second month of treatment. In the long-term period, after 69 months, recurrence of a trophic ulcer was not registered in any case.
Conclusions. The undertaken tactics of treatment of aged and senile patients with venous trophic ulcers is clinically justified and confirmed by the achieved positive results in 100% of patients, which allows recommending it for a wide practical application.

Keywords: varicose veins, venous trophic ulcers, aged and senile patients, minimally invasive technologies, endovenous laser ablation, complex treatment
p. 38-45 of the original issue
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Address for correspondence:
119048, Russian Federation,
Moscow, Dovator Str., 15-1,
I.M. Sechenov First Moscow
State Medical University,
Faculty Surgery Department 2.
Tel.: 89104450671,
e-mail: doctorwing@mail.ru,
Alexey Yu. Krylov
Information about the authors:
Krylov Alexey Yu., MD, Professor of the Faculty Surgery Department No2, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0003-0328-0223
Shulutko Alexander M., MD, Professor of the Faculty Surgery Department No2, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-8001-1601
Khmyrova Svetlana E., PhD, Associate Professor of the Faculty Surgery Department No2, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0003-4455-6716
Osmanov Elkhan G., MD, Professor of the Faculty Surgery Department No2, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0003-1451-1015
Petrovskaya Alexandra A., PhD, Assistant of the Faculty Surgery Department No2, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
http://orcid.org/0000-0003-3839-3287
Contacts | ©Vitebsk State Medical University, 2007