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Khirurgii

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Year 2018 Vol. 26 No 6

GENERAL & SPECIAL SURGERY

O.I. NABOLOTNYI, Y.M. HUPALO, O.E. SHVED, V.G. GURIANOV

SURGICAL TREATMENT OF NON-SAPHENOUS VARICOSE VEINS OF LOWER LIMBS IN WOMEN WITH PELVIC CONGESTION SYNDROME

Scientific and Practical Center for Preventive and Clinical Medicine, Kiev,
Ukraine

Objective. To evaluate the effectiveness of endovascular interventions in the treatment of non-saphenous varicose veins of lower limbs in women with pelvic congestion syndrome.
Methods. The treatment analysis of non-saphenous varicose veins of the lower limbs combined with the pelvic congestion syndrome was conducted in 25 women. The main group consisted of 10 patients with non-saphenous varicose veins, pelvic varices and clinically expressed pelvic congestion syndrome. In this group, patients underwent pelvic phlebography with embolization of the left ovarian vein and miniphlebectomy of non-saphenous varicose veins. Control group included 15 patients with non-saphenous varicose veins, pelvic varices and with poorly expressed or absent clinic of pelvic congestion syndrome. In this group only miniphlebectomy of non-saphenous varicose veins was performed. The results of treatment were evaluated within 2 years. The incidence of varicose vein recurrence and pelvic pains was evaluated.
Results. During the a 2-year observation in 8 patients (80% (95%CI=46%-99%)) of the main group, the clinical symptoms of pelvic congestion syndrome regressed or significantly decreased. In 2 patients a chronic pelvic pain recurred to the intensity of the pre-hospital period. Relapses of varicose veins of the lower limbs were not observed. During a 2-year follow-up period, 1 (6.7%) patient of the control group had a recurrence of non-saphenous varicose in the lower limbs and 1 (6.7%) patient had relapse in the system of the great saphenous vein. In 2 (13%) patients, the intensity of pelvic pain increased.
Conclusions. The embolization of the left ovarian vein in patients with pelvic congestion syndrome, according to the study data, is effective in 80% of cases. Conducting the hybrid interference in case of varicose veins of the lower limbs and pelvic congestion syndrome is effective method for correction of pathological phlebohemodynamics in patients with chronic diseases of the lower limb and pelvic veins.

Keywords: non-saphenous superficial varicose veins of the lower limbs, pelvic congestion syndrome, pelvic phlebography, embolization, miniphlebectomy
p. 669-676 of the original issue
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Address for correspondence:
01014, Ukraine,
Kiev, Verkhnaya Str., 5,
Scientific and Practical Center
For Preventive and Clinical Medicine,
Scientific Department of Minimally Invasive Surgery,
Tel.: +380978430155,
e-mail: oleh.nabolotnyi@gmail.com,
Oleh I. Nabolotnyi
Information about the authors:
Nabolotnyi Oleh I., Junior Researcher of the Scientific Department of Minimally Invasive Surgery, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
https://orcid.org/0000-0002-4273-5799
Hupalo Yrii M., PhD, Leading Researcher of the Scientific Department of Minimally Invasive Surgery, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
https://orcid.org/0000-0002-9467-115X
Shved Olena E., PhD, Senior Researcher of the Scientific Department of Minimally Invasive Surgery, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
https://orcid.org/0000-0002-7652-9301
Gurianov Vitaly G., PhD, Associate Professor, Senior Researcher of the Scientific Departments of Medical Care Organization, Scientific and Practical Center for Preventive and Clinical Medicine, Kiev, Ukraine.
https://orcid.org/0000-0001-8509-6301
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