Terlecki Piotr, Zubilewicz Tomasz, Przywara Stanisław, Iłżecki Marek, Karakuła Wacław, Hus Marek, Nowaczyńska Aleksandra, Kuczyński Maciej
Department of Vascular Surgery and Angiology, Medical University of Lublin, Poland.
Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland.
Ann Agric Environ Med. 2013;20(4):880-3.
The presented report presents a minimally invasive approach for the treatment of varicose veins in patients with chronic venous disease and coexisting von Willebrand disease, the most common inherited bleeding disorder. Conventional stripping of an insufficient great saphenous vein and varicose vein surgery, carries a potential risk of serious bleeding complications in this specific group of patients. It is related to the extent of open surgery, significant tissue trauma, and possible post-operative bleeding of wounds. Less aggressive techniques, such as endovenous laser treatment or radiofrequency ablation, gain increasing popularity as a valuable and equally efficient alternative to conventional surgery in patients with varicose veins. Both of these endovenous techniques seem to have special indications in patients with bleeding disorders. Shortening of hospitalization, quick recovery time and return to normal daily activities, optimal cosmetic effect of the procedure, are also advantageous. The paper presents the technique and results of endovenous laser treatment of great saphenous vein insufficiency and varicose veins in a patient with type I von Willebrand disease. Available data on peri-operative care standards, optimization of the safety of procedures, and prevention of bleeding complications in surgical patients with von Willebrand disease, specifically undergoing varicose veins surgery are analysed.
本报告介绍了一种微创方法，用于治疗患有慢性静脉疾病并伴有最常见的遗传性出血性疾病——血管性血友病的患者的静脉曲张。对于这一特定患者群体，传统的大隐静脉功能不全剥脱术和静脉曲张手术存在严重出血并发症的潜在风险。这与开放手术的范围、显著的组织创伤以及伤口可能的术后出血有关。在静脉曲张患者中，诸如静脉腔内激光治疗或射频消融等侵入性较小的技术，作为传统手术的一种有价值且同样有效的替代方法，越来越受到欢迎。这两种静脉腔内技术在出血性疾病患者中似乎都有特殊适应症。缩短住院时间、快速恢复时间并回归正常日常活动、手术具有最佳的美容效果，这些也都是有利之处。本文介绍了一名患有I型血管性血友病的患者的大隐静脉功能不全和静脉曲张的静脉腔内激光治疗技术及结果。分析了关于血管性血友病手术患者，特别是接受静脉曲张手术患者的围手术期护理标准、手术安全性优化以及出血并发症预防的现有数据。
