Comparative characteristics of conservative and surgical methods of treatment of chronic venous insufficiency

Abstract

Introduction. The prevalence of chronic venous insufficiency is 5–50%, and trophic skin changes, including leg ulcers, occur in 1–5% of the population. The course of decompensated forms of chronic venous insufficiency is characterized by slow healing and a high frequency of recurrence of trophic ulcers, which leads to permanent disability in more than half (51.2%) of patients. The issues of surgical treatment of decompensated forms of chronic venous insufficiency have not been fully resolved and require further research. The aim of the study was to compare the early and long-term results of surgical and conservative treatment of chronic venous insufficiency of the lower extremities. Research materials and methods. The results of treatment of chronic venous insufficiency in 929 patients were analyzed. Depending on the treatment performed, the patients were divided into: I A group – 432 (46.5%) patients who were operated on for varicose veins; І B group – 154 (16.6%) patients who were operated on for superficial vein thrombosis; І C group – 131 (14.1%) patients with post-thrombotic disease; II group – 212 (22.8%) patients who received only conservative treatment. Research results and their discussion. Cumulative analysis showed good and satisfactory results of treatment during 3 years of observation in 86.6%, 89.6%, 86.7% and 18.3% of patients of I A, I B, I C and II groups, respectively. Quantitative assessment of treatment results showed that the total clinical score before surgery in groups I A, I B and I C was 15.4±2.42; 16.2±2.24 and 14.9±1.63 points, and after the operation – 0.81±0.17; 1.22±0.31 and 1.78±0.26, respectively. The smallest regression of clinical symptoms was observed in the II group of patients - from 15.8±2.26 to 5.62±1.78 points. Conclusion. Surgical treatment of decompensated forms of chronic venous insufficiency made it possible to achieve a positive result in 86.6–89.6% of patients, against 18.3% with isolated conservative treatment. With surgical treatment, it was possible to reduce the percentage of progression of chronic venous insufficiency from 44.1% to 1.8–16.7%.