Novosti
Khirurgii

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Year 2012 Vol. 20 No 6

GENERAL AND SPECIAL SURGERY

A.A. LYZIKOV 1, J.W. NEILSON 2, A.A. PECHENKIN 1.

EFFICIENCY OF AUTOVENOUS RECONSTRUCTIONS OF AORTO-ILIAC SEGMENT OCCLUSIVE LESIONS IN PATIENTS WITH HIGH RISK OF PURULENT-NECROTIC COMPLICATIONS

EE “Gomel State medical university1”,
The Republic of Belarus
Baylor University2, Texas,
USA

Objectives. To analyze the efficiency of the aorto-iliac segment reconstructions using the femoral vein in patients with high risk of infectious complications.
Methods. During the period of 2010 to 2011 we performed 10 reconstructions of the femoral vein aorto-iliac segment at Gomel regional vascular surgery department. 4 patients were operated on for the late complications of vascular prosthesis, 1 patient – for the suppuration of the artificial prosthesis and presence of the enteric-prosthetic fistula, 5 patients underwent initial reconstructions for the critical ischemia with purulent-necrotic lesions.
Results. The adequate revascularization was obtained in all patients operated on for late complications. Symptoms of venous insufficiency were not observed in this group. The patient operated on for suppuration of the artificial prosthesis and presence of the enteric-prosthetic fistula died on the 8th day. We achieved the adequate revascularization in patients with critical ischemia with purulent-necrotic changes as well. In this group the postoperative period was accompanied by the marked disturbance of the lymphatic outflow during the nearest postoperative period. There were no signs of venous insufficiency in the distant period.
Conclusions. The adequate revascularization was obtained in all cases. In repeatedly operated patients the intervention didn’t cause the lymphatic outflow disturbances during the whole period of observation. In patients at the stage of the critical ischemia with purulent-necrotic lesions the postoperative wounds healed with the secondary tension with the signs of lymphatic-venous insufficiency in the nearest postoperative period. There were no disturbances of the lymphatic outflow in the distant period in all investigated groups and we may consider the use of the femoral vein to reconstruct the aorto-iliac segment in patients with high risk of purulent-necrotic complications to be effective and safe method of revascularization.

Keywords: femoral vein, aorto-iliac reconstructions, artificial vascular prosthesis, infection of prosthesis, purulent-septic complications
p. 35 – 40 of the original issue
References
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Address for correspondence:
230006, Respublika Belarus, g. Gomel, ul. Lange, d. 5 UO «Gomelskiy gosudarstvennyiy meditsinskiy universitet», kafedra khirurgicheskih bolezney ¹3 s kursom serdechno-sosudistoy khirurgii,
e-mail: lyzikov@mail.ru,
Lyizikov Aleksey Anatolevich
Information about the authors:
Lyzikov A.A. Candidate of medical sciences, associate professor of the surgical diseases chair ¹3 with the course of the cardiovascular surgery of EE “Gomel State Medical University”
Neilson J.W. Professor of Baylor University, Texas, USA
Pechenkin A.A. Assistant of the surgical diseases chair ¹3 with the course of the cardiovascular surgery of EE “Gomel State Medical University”.
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