| Abstrakt: |
Authors investigated the frequency of varicose disease recurrence after crossectomy, classified clinical types and proposed the tactics of treatment of this group of patients. 258 patients with varicose disease recurrence were examined and operated. In 179 cases (69,4%) there were found differ pathological changes in the place of saphenofemoral junction, which were collected in several groups. Pathological stump of the great saphenous vein was in 155 lower limbs (60,1%). 12 patients (4,7%) had not ligated saphenofemoral junction. And in 12 patients (4,7%) there were found signs of neoangiogenesis. We proposed the scheme of tactical actions in cases of pathological changes in the place of saphenofemoral junction. The absolute indication for surgery is present saphenofemoral junction and trunk of the great saphenous vein. Furthermore, recection of vein's stump is necessary if its length is more 3 cm, that always combined with varicose tranformation of the varicosities. If the linear size of stump is from 1 to 3 cm its resection have to be done only in case of considerable varicosities. In not severe lesions of varicosities it is enough to perform sclerotherapy or mini-phlebectomy of involved vessels. There is not necessary to surgery if the stump is short (less 1 cm). In this case the phlebosclerotherapy or mini-phlebectomy of varicosities are expedient. The method of choice for removal of neoangiogenesis is phlebosclerotherapy. Our results showed that treatment of patients with varicose disease recurrence is in special phlebological centers or vascular departments and improvement of technique of Troyanov-Trendelenburg operation. |
