[Endovenous laser photocoagulation for the treatment of varicose vein disease of the lower extremities].

Varicose vein disease of the lower extremities is a challenging socio-medical problem because it is responsible for high disability rate and requires substantial expenditures. According to different authors, the disease occurs in 10.4-23.0% of men and 29.5-39.0% of women. Numerous methods for its treatment have been proposed, each having advantages and drawbacks. The main criteria for the efficiency of treatment are the injury rate, aesthetic outcome, and frequency of relapses. These criteria can be met if new methods are developed allowing for good cosmetic results without detriment to clinical efficiency of radical operation. This paper presents results of analysis of original and published data on the practical application of endovenous laser photocoagulation for the treatment of varicose vein disease A total of 74 patients (79 legs) were operated by this method between 2006 and 2008. Ecchymosis occurred in 85.1% of the patients, induration in 18.9%, skin hyperpygmentation in 24.3%, paresthesia in 14.8%, greater saphenous vein thrombophlebitis and thigh hematoma in 2.7%, skin burn in 1.3%. Complete occlusion was achieved in all patients. No relapses were documented during a 18 month follow-up period. Quality of life (SF-36 questionnaire) improved on weeks and 12 after surgery. It decreased week after surgery (AVVQ) but improved thereafter. A similar trend was observed when quality of life was evaluated (VCSS) on week 12 postoperatively. It is concluded that endovenous laser photocoagulation is an efficacious method for the treatment of varicose vein disease but further randomized studies are needed to better assess its reliability and safety.

[Endoscopic subfascial dissection of perforating veins of lower legs in patients with venous ulcers].

Prospective analysis of the results of endoscopic subfascial dissection of perforating veins of lower legs in 68 patients with venous ulcers is presented. Four patients developed postoperative wound infection. Mean duration of hospitalization was 4.5 days. The patients were able to resume routine daily activity within 8 days after surgery. Mean length of ulcer healing was 7.0 months. Complete healing required 3 months in 22.1% of the patients, 6 months in 38.2%, 9 months in 66.2%, and 1 year in 97.1%. Ulcers recurred in 2 patients. Mean clinical and disability scores 8 months after surgery were on an average very low. It is concluded that subfascial dissection of perforating veins of lower legs in patients with venous ulcers improves clinical symptoms, promotes healing of ulcers, produces minimal postoperative complications, and plays an important role in correction of concomitant pathology.