Year 2013 Vol. 21 No 3

INFORMATION TECHNOLOGIES IN SURGERY

S.A. SUSHKOU, G.D. KOROBOV, O.D. MYADELETS

A METHOD OF DETECTION OF POSTERIOR TIBIAL VENOUS WALL ATROPHY AT VARICOSE DISEASE

EE “Vitebsk State Medical University”
The Republic of Belarus

Objectives. To work out the diagnostic method of atrophy of the posterior tibial veins wall at varicose disease.
Methods. Morphological changes in the wall of the posterior tibial veins at varicose disease were studied in 43 patients (females – 26/60,5%, males – 17/39,5%). The patient’s age varied between 24-66, the average age – 46,9±8,5 years (М±σ). Disease duration oscillated between 1-30 years (the average – 12,7±7,3 лет years, М±σ). The material for histological studies was taken during operations from the posterior tibial veins. The histological preparations were stained with hematoxylin-eosin, examined by Heidenhain and studied by means of light microscopy. Volumetric ratios of tissue components were evaluated by the method of G.G. Avtandilov. The age, duration of disease, character of work activity, body mass index, degree of retrograde flow in the femoral and popliteal veins were considered as the influencing factors. For probabilistic model providing the diagnostics of atrophic processes in the deep veins the discriminant analysis, logistic regression, ROC-analysis have been used as a basis of the most available clinical data.
Results. The simulative probabilistic model permitted to suggest a diagnostic method providing the detection of atrophic processes in the posterior tibial veins on the results basis of available instrumental and clinical studies has been worked out. Verification of the method in the control samples showed that all cases of diseases for which presence of atrophy was revealed by using the expert way (conclusion of a histologist), have been classified correctly with the help of calculated values (there were no false-negative diagnoses). Only in one case among patients without histologically detected arthrophy the calculated value turned out to be false positive which composed 10%. The sensitivity of the worked out method was 88,2%, specificity – 88,5%.
Conclusions. The worked out non-invasive evaluation method of the venous wall of the posterior tibial vein can be used to determine the tactics and choice of treatment of varicose disease.

Keywords: primary varicose veins, condition of deep veins, morphological changes of the venous wall, diagnostics
p. 90 – 102 of the original issue
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Address for correspondence:
210023, Respublika Belarus', g. Vitebsk, pr. Frunze, d. 27, UO "Vitebskii gosudarstvennyi meditsinskii universitet", kafedra obshchei khirurgii,
e-mail: sergery@nm.ru,
Sushkou Sergei Al'bertovich
Information about the authors:
Sushkou S.A. PhD, associate professor, vice-rector on scientific research work of EE “Vitebsk State Medical University”.
Korobov G.D. PhD, associate professor of public health and public health care of EE “Vitebsk State Medical University”.
Myadelets O.D. MD, professor, a head of histology, cytology and embryology chair of EE “Vitebsk State Medical University”.
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