Mehmet Şenel BADEMCİ, Orhan GÖKALP, Serdar BAYRAK, Barçın ÖZCEM, Haydar YAŞA, Ali GÜRBÜZ, Ufuk YETKİN, İsmail YÜREKLİ

Kronik venöz yetersizlik olgularında eksternal banding uygulamalarımız

Amaç: Bu çalışmada safenofemoral bileşke yetersizliği olan hastalardaki eksternal banding uygulama sonuçları araştırıldı. Çalışma planı: Ekim 2005 - Ocak 2011 tarihleri arasında kliniğimize kronik venöz yetersizlik semptomları ile başvuran ve Dopler ultrasonografi (USG) ile safenofemoral bileşke yetersizliği tanısı konan 28 hasta (16 kadın, 12 erkek; ort. yaş 45.5 yıl; dağılım 19-62 yıl) dahil edildi. Hastaların tümü ameliyat öncesindeki tıbbi öykü ve muayene bulgularına göre ve ameliyat sonrası 1, 2, 12. ve 24. aylarda değerlendirildi. Dopler USG, ameliyat öncesi ve ameliyat sonrası yapıldı. Venöz Klinik Skorlama Sistemi de kullanıldı. Bulgular: Hiçbir hastada ameliyata bağlı bir komplikasyon görülmedi. Hastaların dördü iki kere ameliyat edildi. Hasta verilerinin ameliyat öncesinde yapılan değerlendirmesinde, safen ven çap oranının reflü süresi uzadıkça arttığı açıkça görüldü. Venöz klinik skorlama sistemi ile değerlendirildiği üzere, ortalama skor grup 1de 3.2, grup 2de 3.8 idi. Hastaların hiçbirinde ameliyatın ilk üç ayı içerisinde hastalık nüks etmedi. Doppler USG bulgularına göre, patolojik reflüye rastlanmadı. Sonuç: Safenofemoral bileşke yetersizliği olan uygun hastalarda eksternal banding gerek semptomatik açıdan, gerekse safen ven çapının düzelmesi ve reflünün önlenmesi açısından başarılı ve tatmin edici sonuçlar sağlayan önemli bir cerrahi yöntemdir.

Chronic venous insufficiency cases in the practice of external banding

Background: This study aims to investigate the outcomes of the external banding application in patients with saphenofemoral junction insufficiency. Methods: Between October 2005 and January 2011, 28 patients (16 females, 12 males; mean age 45.5 years; range 19 to 62 years) who were admitted with chronic venous insufficiency symptoms in our clinic and diagnosed with saphenofemoral junction insufficiency through Dopler ultrasonography (USG) were included. All patients were evaluated according to their medical history and examination before surgery and in 1, 2, 12, and 24 months following surgery. Doppler USG was used before and after surgery. Venous Clinical Scoring System was also performed. Results: No surgery-related complication was seen in any patients. Of the patients, four were operated twice. Preoperative evaluation of the patient data clearly showed that the ratio of the diameter of the saphenous vein increased with increasing duration of reflux time. The mean score was 3.2 and 3.8 in group 1 and group 2, respectively, as assessed by the venous clinical scoring system at baseline. No patient had recurrent disease within the first three months of surgery. No pathological reflux was shown in Doppler USG findings. Conclusion: External banding is a successful and satisfactory surgical modality, resulting in both relieving symptoms and fixing the diameter of saphenous vein by avoiding from reflux in eligible patients with saphenofemoral junction insufficiency.

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