Prezentare

Dr.Capatana Ioan
-medic primar chirurgie generala-

Tel Contact: 0733/082752

About Varicose VeinsDespre varice

The patient observes the condition first at the level of the ankle and the leg (incipient veins dilatations which grow in time giving the feeling of weight and pain especially in the orthostatic position.
There are various methods of treating the varicous veins disease, but the only efficient and long lasting treatment is the surgical one which needs to start at the early stages. The surgical treatment is compulsory when skin lesions appear such as: hyperpigmantation, eczema, sclero-atrophic cellulite, leg ulcer.
This treatment dissolves the pathologic dilated veins, which in orthostatism stores a large volume of flow backward blood from the deep veins circulation. A large amount of stored blood in the limbs will affect the blood circulation to other organs of the body causing important disorders at the level of heart, liver and pancreas.
To prevent these disorders, to stop the pain and to eliminate the feeling of heavy limbs and also for aesthetic reasons it is necessary to proceed with the veins excision.

In 1962, Dr. Horatiu Angelescu has promoted the procedure ‘non stripping surgery and in 1969 he has become member of the French Society of phlebology. In 1969 at the World Congress of Phlebology in Essen-Germany presents the film “Non stripping Vericous Veins Surgery”. During this Congress using his method, he made a demonstrative operation at the Cardio – Vascular Surgery Clinic in Essen.
Afterwards Dr Angelescu, has presented his method at the Phlebology Congress in Denmark, Argentina, and Japan.
The surgical procedure proposed by Dr. Horatiu. Angelescu- the resection of the main saphenous vein, of the small saphenous vein, segmentation saphenoustomy , ligation and the resection of the communicating and perforated veins, on pre marked areas – it is an aesthetic surgery. The skin incisions are small and are placed in the skin folds, which will disappear after healing.

CONCLUSIONS

1. The presence of the patient for a consultancy needs to be directed by GP, cardiologists, dermatologists and it needs to be carried out at the incipient phase of the condition.
2. An incorrect, non surgical treatment could lead to complications.
3. Dissolving the pathological dilated veins through surgical treatment could cure the condition.

I consider that the procedure used by Dr. Horatiu Angelescu is a successful substitute to the classical “stripping” method considering the following aspects:
1. I is not a blind surgery
2. It is a non bleeding procedure (non-stripping the veins)
3. It is aesthetic being a non invasive surgery.
4. The connections of the saphenous vein with the other structures are not destroyed such as nerves, lymphatic and arterioles structures.
5. The deep veins system will not be affected because the perforated veins are not stripped.
6. The healthy segments of the remaining saphenous vein, could be used if necessary on other surgical operations.
7. The operation could be under gone ambulatory in a clinic system of 1 day or in the hospital for 1 to 3 days depending on each case.
8. The method is non traumatic and adapted to each patient so is has a positive influence on the mental side of the patient.
9. The cost of it is in accordance with the complexity of the operation and the system where is conducted.

Bolnavul observa boala varicoasa, mai intai la nivelul gleznei si gambei (dilatatii venoase incipiente care se accentueaza in timp si dau senzatia de greutate si durere, mai ales in pozitia ortostatica).
Exista mai multe metode de a trata boala varicoasa,dar singurul tratament cu adevarat eficient si de durata al acestei boli, este cel chirurgical, aplicat cat mai precoce.Tratamentul chirurgical trebuie indicat obligatoriu si atunci cand apar leziuni cutanate (hiperpigmentare, eczema, celulita sclero-atrofica, ulcer de gamba)
Acest tratament desfiinteaza venele dilatate patologic, care, in ortostatism, inmagazineaza un volum insemnat de sange refluat din circulatia venoasa profunda.Un mare volum de sange stocat in membrele pelvine ar impieta circulatia sanguina din alte organe ale corpului provocand tulburari importante la nivelul inimii, ficatului, pancreasului etc.
Pentru prevenirea acestor tulburari, pentru eliminarea durerii, a senzatiei de greutate in membrele inferioare, dar nu in ultimul rand pentru aspectul estetic, se impune excizia varicelor.
In 1962, dr.Horatiu Angelescu a promovat procedeul “Chirurgia varicelor fara smulgere”, iar in 1969 a devenit membru al Societatii Franceze de Flebologie. Tot in 1969, la Congresul Mondial de Flebologie de la Essen-Germania, prezinta filmul “Chirurgia varicelor fara stripping”. In cadrul acestui congres, cu metoda sa, dr.Angelescu opereaza demonstrativ la Clinica de Chirurgie Cardio-Vasculara din Essen.
Ulterior, dr.Angelescu a prezentat metoda sa operatorie si la Congresele de Flebologie din Danemarca, Argentina, Japonia etc.
Procedeul chirurgical propus de dr.Horatiu Angelescu – crosectomia safenei mari, dupa caz si a safenei mici, safenectimii segmentare, ligatura si rezectia de vene comunicante si perforante, pe zone presemnate – este o chirurgie estetica. Inciziile cutanate sunt mici si sunt plasate in pliurile pielii. Dupa cicatrizare, acestea dispar in totalitate.

Citeste interviu cu Dr. Horatiu Angelescu:

Cinci greseli capitale in tratarea varicelor

CONCLUZII:

1.Prezentarea bolnavului la consultatie trebuie sa se efectueze in faza incipienta a bolii pentru a preintampina complicatiile. Astfel, un rol important in indrumare, il au medicii de familie, dar si medicii specialisti de medicina interna, cardiologie, dermatologie etc.
2.Un tratament incorect, nechirurgical, poate duce la instalarea complicatiilor.
3.Desfiintarea segmentului venos, patologic dilatat si a refluxului venos, prin tratament chirurgical, duce la vindecarea pacientului cu varice .
Consider ca procedeul aplicat de dr.Horatiu Angelescu “Chirurgia varicelor fara stripping” substituie cu mare succes interventia clasica cu “stripping” din urmatoarele motive:
1.Nu este o chirurgie ”oarba”
2.Este un procedeu nesangerand (nesmulgandu-se venele)
3.Are un caracter estetic fiind o chirurgie noninvaziva
4.Nu se distrug legaturile venei safene cu celelalte structuri, nervi, limfatice, arteriole etc
5.Nu se poate ajunge la leziuni ale sistemului venos profund, nesmulgandu-se venele perforante
6.Segmentele sanatoase de vena safena ramase, pot fi folosite la nevoie in alte interventii chirurgicale
7.Operatia se poate efectua ambulator, in sistem clinic de o zi sau prin internare intre 1 si 3 zile ,in functie de caz, iar recuperarea nu este de durata, pacientul avand indicatia sa efectueze plimbari chiar din ziua imediat urmatoare interventiei.
8.Influenteaza favorabil psihicul pacientului, metoda fiind netraumatizanta si adaptabila fiecarui bolnav in parte.
9.Costurile sunt in functie de complexitatea interventiei si regimul in care se efectueaza

Aici poti pune o intrebare legata de problema ta de sanatate

eXTReMe Tracker