ABSTRACT
The paper analyzed results of surgical treatment of the 94 patients with Leriche syndrome and researched the long-term results of 52 (55.3%) cases. Following 5 years patency after aortofemoral reconstructions was observed in 34 (65.4%) cases. Lower extremity preservation was observed in 35 (67.3%) patients. Five year survival was 76.9%, and only 53.8% patients received adequate postoperative diagnostic monitory and therapy.
Subject(s)
Leriche Syndrome/surgery , Vascular Surgical Procedures/methods , Female , Humans , Male , Middle Aged , Postoperative Complications/prevention & control , Time Factors , Treatment OutcomeABSTRACT
Comparative analysis of the various methods of surgical treatment efficacy was conducted in patients suffering Leriche syndrome, including bifurcational, one-sided and multilevel reconstruction. Clinical indices of intra- and postoperative periods, the frequency of thrombotic and nonthrombotic complications occurrence, lethality for every kind of intervention were analyzed. It was established, that tactics of surgical treatment of Leriche syndrome ought to be individualized, but in presence of clinical and anatomical conditions the one-sided reconstruction must be preferred.
Subject(s)
Blood Vessel Prosthesis Implantation/methods , Leriche Syndrome/surgery , Aorta, Abdominal/surgery , Humans , Incidence , Leriche Syndrome/diagnosis , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Treatment OutcomeABSTRACT
The results of treatment of 131 patients, suffering multilevel atherosclerotic affection of abdominal aorta and the main arteries of the lower extremity, are adduced. Algorhythm of arterial reconstruction performance depending on the spread of the aorto-iliac and femoro-politeal segments affection, was elaborated. There were applied two methods of treatment: reconstruction of aorto-iliac segment only and simultaneous reconstruction of arteries on two levels. The differentiated approach to performance of arterial reconstruction application have permitted to achieve positive result in 80% of patients in terms of 5-year follow-up. The lower extremity was secured in 83% of them, mortality had constituted 20%.
Subject(s)
Atherosclerosis/surgery , Blood Vessel Prosthesis Implantation/methods , Lower Extremity/blood supply , Adult , Aged , Aged, 80 and over , Aorta, Abdominal/surgery , Atherosclerosis/mortality , Disease-Free Survival , Female , Femoral Artery/surgery , Humans , Iliac Artery/surgery , Male , Middle Aged , Popliteal Artery/surgery , Time Factors , Treatment OutcomeABSTRACT
The method of performance and immediate results of miniinvasive lumbar sympathectomy using retroperitoneal miniaccess were adduced in the work. In 2005 yr on the base of division of vascular surgery were operated 19 patients. Application of endoscopic instruments and optic system of illumination gave the possibility to remove lumbar sympathetic nodes in conditions of narrow (3-5 cm) surgical access and operative field. Introduction of miniinvasive method have promoted to reduce essentially the postoperative complications rate, the pain syndrome intensity, the reduction of duration of the patients postoperative rehabilitation, the cosmetic effect raising.
Subject(s)
Arteriosclerosis Obliterans/surgery , Lower Extremity/blood supply , Lumbosacral Region/innervation , Sympathectomy/methods , Adult , Aged , Female , Humans , Lumbosacral Region/surgery , Male , Middle Aged , Minimally Invasive Surgical Procedures , Treatment OutcomeABSTRACT
Results of examination of 108 patients with the Raynaud's phenomenon were analyzed. The differential diagnosis algorhythm for the disease and the syndrome as well was elaborated. The leading role of the clinical features and the data of the physical examination methods in the diagnosis establishing was proved. Diagnostic complex for the functional state investigation of the upper extremity microvascular bed was elaborated.
Subject(s)
Raynaud Disease/diagnosis , Adolescent , Adult , Aged , Algorithms , Child , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
Peculiarities of anatomic structure (disposition, form, size) of stellate ganglion, II and III thoracic sympathetic ganglions together with their branches were suggested. There were established their morphological differences. Peculiarities of anatomical structure of the "lateral branch" II sympathetic ganglions were studied, its role in occurrence of the disease recurrence after performance of the thoracic sympathectomy performance was proved. Basing on the results achieved the method of thoracoscopic sympathectomy performance for Raynaud's phenomenon was elaborated.
Subject(s)
Sympathectomy/methods , Humans , Neck , Stellate Ganglion/anatomy & histology , ThoraxABSTRACT
Peculiarities of anatomical structure of cervical and thoracic parts of sympathetic trunk were studied. There was trusted, that in the upper extremities innervation a "lateral branch" of II thoracic sympathetic ganglion owes important significance. The method of TV surgical thoracic sympathectomy, permitting to improve late follow-up results of treatment in patients with Raynaud disease was elaborated.
Subject(s)
Ganglia, Sympathetic/anatomy & histology , Raynaud Disease/surgery , Sympathectomy/methods , Thoracoscopy/methods , Thorax/anatomy & histology , Thorax/innervation , Adolescent , Adult , Female , Humans , Ischemia/physiopathology , Male , Middle Aged , Upper Extremity/blood supply , Upper Extremity/physiopathologyABSTRACT
Experience of surgical treatment of Raynaud's disease with application of thoracoscopic sympathectomy (TSSE) method using telesurgical technique was analyzed. Operative intervention was performed in 17 patients. Stable positive result was observed in all the patients for the period of 2 years and more. Regarding the intervention traumaticity, efficacy of treatment in immediate and late postoperative period, the patients quality of life, the duration of stay in hospital and the value of treatment, the TSSE results, performed with telesurgical technique application, were significantly better than the results of thoracotomic sympathectomy. Peculiarities of anesthesiologic support and predominance of application of monopulmonary artificial ventilation of lungs during performance of thoracic sympathectomy were noted.
Subject(s)
Sympathectomy/methods , Telemedicine/methods , Thoracic Diseases/surgery , HumansABSTRACT
The article describes an experience with the surgical treatment of repeated re-thromboses after aorto-femoral reconstructions with a bifurcation explant in 34 patients with the Leriche syndrome of atherosclerotic etiology who were subjected to 110 reoperations. Different kinds of reconstructions for revascularization of extremities are considered. Favorable results were obtained in 76.5% of the cases. Lethality was 2.73% per 110 operations. Long-term results were studied during 13 years. The bifurcation explant was found to be functioning in 30% of the cases observed.
