Hamit Serdar BAŞBUĞ, Seyhan BABAROĞLU, Macit BİTARGİL, Kanat ÖZIŞIK, Hakan GÖÇER, Yalçın GÜNERHAN

Renkli Doppler eşliğinde mini insizyon ile perforan ven ligasyonu halen geçerli bir alternatif mi?

Amaç: Bu çalışmada perforan ven yetmezliğinin klinik önemi vurgulandı ve yetmezlik bulunan alt ekstremite perforan venlerine yönelik tanı ve tedavi deneyimimiz paylaşıldı.Çalışmaplanı:Aralık 2012 - Aralık 2014 tarihleri arasında perforan ven yetmezliği nedeniyle renkli Doppler ultrason (RDUS) eşliğinde mini insizyonla perforan ven ligasyonu yapılan 36 hasta (19 erkek, 17 kadın; ort. yaş 40.7±11.3 yıl; dağılım 20-68 yıl) retrospektif olarak incelendi. Valsalva manevrası sırasında en az 350 milisaniye venöz reflüsü olan veya ayakta ölçülen perforan ven çapı 4 mm'nin üzerinde olan semptomatik hastalar çalışmaya dahil edildi. Tüm etkilenen ekstremiteler Klinik, Etyolojik, Anatomik, Patofizyolojik sınıflama sistemine göre sınıflandırıldı. Klinik, Etyolojik, Anatomik, Patofizyolojik sınıf lamasına göre, 24 hasta (%66.7) C4 (Klinik sınıf 4), beş hasta (%13.9) C5 ve yedi hasta (%19.4) C6 idi. Ameliyat öncesi ve sonrası venöz klinik önem skorları (VKÖS) hesaplandı ve karşılaştırıldı. Hastalar ameliyat sonrası birinci hafta ve üçüncü ayda RDUS ile değerlendirildi.Bul gu lar: Ortalama perforan ven çapı 4.43±0.35 mm (dağılım 4.0-5.1 mm) idi. Ameliyat sırası komplikasyon gelişmedi. Ameliyat sonrası enfeksiyon, derin ven trombozu, parezi ya da parestezi gibi ciddi komplikasyonlar görülmedi. Ameliyat öncesi ortalama VKÖS skoru 12.25±3.6 iken, ameliyat sonrası VKÖS skoru istatistiksel olarak anlamlı şekilde 2.25±0.8 idi (p

Is color Doppler ultrasound-assisted perforating vein ligation with a mini-incision still a viable alternative?

Background: This study aims to emphasize the clinical significance of perforating vein insufficiency and to share our diagnosis and treatment experience for lower extremity perforating veins with insufficiency.Methods: Thirty-six patients (19 males, 17 females; mean age 40.7±11.3 years; range 20 to 68 years) who underwent colored Doppler ultrasound (CDUS) assisted perforating vein ligation with mini-incision due to perforating vein insufficiency between December 2012 and December 2014 were retrospectively analyzed. Symptomatic patients having at least 350 milliseconds of venous reflux during Valsalva maneuver or perforating vein diameter greater than 4 mm in the erect position were included in the study. All affected limbs were classified according to the ClinicalEtiological-Anatomical-Pathophysiological classification system. According to Clinical-Etiological-Anatomical-Pathophysiological classification, 24 patients (66.7%) were C4 (Clinical class 4), five patients (13.9%) were C5, and seven patients (19.4%) were C6. Preoperative and postoperative venous clinical severity scores (VCSS) were calculated and compared. Patients were evaluated with CDUS at postoperative first week and third month.Results: Mean perforating vein diameter was 4.43±0.35 mm (range 4.0 to 5.1 mm). No intraoperative complications occurred. No severe complications including infection, deep vein thrombosis, paresis, or paresthesia were observed postoperatively. While mean preoperative VCSS score was 12.25±3.6, postoperative VCSS score was 2.25±0.8 with a significant statistical difference (p

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