Evaluation of surgical techniques on the deep venous system in the management of post phlebitic limb syndrom

This work was conducted upon thirty limbs in 25 patients with deep venous insuficiency 24 cases men and one case women ranged in age at the time of surgery 28 years to 60 years [MEAN 44 years]. Presenting symptoms included ulcerophelic skin, calf oedema, static dermatitis and venous claudication, accordingly the indication of surgery was divided into two main groups: calf oedema [7 limbs] static oedema and static ulceration [23 limbs]. All cases have been exposed to full clinical examination, haemodynamic testing, venography and venous valve incompetency testing using doppler flowmeter. Valve repair was indicated in 14 cases, valve transposition was requested in 13 cases while crossover graft was delivered in 3 cases. Postoperative result qualify the degree of venous compansation in the exterimity with particulate regared to the dependency of elastic stocking. Excellent compensation was considered as full relief of the clinical condition without elastic stock, good result, full compensation with only elastic support, fair mild to moderate sysmptom with elastic support. Poor, no improvement or recurant of symptoms. Excellent results was obtained in 15 cases while good results was in 6 cases. Relfux venography is mandatory since superficial varicose veins is an unreliable about the status of deep vein valve function. Successful management of venous decompensation in the lower extremity require attention to the following requists factors, the type of the valve dysfunction, the condition of the venous lumen, the competency of the saphenofemoral valve and the other compensatory operation

Survival and quality of life after warren shunt

55 non selected cirrhotic patients underwent selective shunts from January 1980 to January 1988. All cases were admitted to the hospital because of upper gastrointestinal haemorrhage, and all had radiological and endoscopic evidence of esophageal or gastric varices, or both. 45 patients were male and 10 case female, the mean age was 38 years. [range 20 to 60]. 31 cases were in class A and 18 were in class B and 6 cases in class C. No prophylactic Shunt was conducted. Ten seven patients underwent end to end selective warren shunt while 40 cases end to side and 5 cases modified warren procedure. The predicted overall survival for 5 years period is 59%. Overall death associated with shunt procedure 37% with end to end selective renosplenic shunt-35% end to side shunt 30% with modified warren. The predicted 5 year survival was 83.4% in class A which differ significantly from the predicted survival in 24 patients in classes B and C which was only 36%. No. differance in survival rates in bilharzial and non bilharzial cases