Quarto Gennaro, Amato Bruno, Benassai Giacomo, Apperti Marco, Sellitti Antonio, Sivero Luigi, Furino Ermenegildo
Dept. of Clinical Medicine and Surgery, Federico II University, 5, Pansini Street, 80131 Naples - Italy , Ph/.
Dept. of Clinical Medicine and Surgery, Federico II University, Naples ( Italy ).
Open Med (Wars). 2016 Nov 19;11(1):471-476. doi: 10.1515/med-2016-0083. eCollection 2016.
Aging is one of the major risk factors for varicose veins. The same is for Knee and Hip Osteoarthritis. Most of the patients undergoing to Hip (THA) or Knee (TKA) arthroplasty are over sixteen. Varicose veins, excluding thrombophilia, are the most significant risk factors for VTE after THA and TKA. This study investigates on the usefulness of prophylactic treatment of GSV insufficiency in elderly patients undergoing to orthopedic surgery. A retrospective study enrolling 44 over-sixty five patients, undergoing to TKA or THA. 24 patients underwent to traditional surgery and 20 to EVLA. The presence of evident varicosities and/or a saphenic reflux lasting > 500 ms has been considered as operability criterion. Both in surgery and EVLA group has been performed the ablation of visible varicosities and only saphenic refluxing traits.
1 case of symptomatic DVT was recorded after arthroplasty. A statistically significant difference (p = 0.006) of recovery time between surgery and EVLA groups has been detected. There is not a statistically significant difference in long-term recurrence rate between surgery and EVLA.
It is useful to program GSV surgery, before treat hip or knee. This study showed a 50% decrease in the incidence of postoperative DVT.
衰老为静脉曲张的主要风险因素之一。膝关节和髋关节骨关节炎亦是如此。大多数接受髋关节置换术（THA）或膝关节置换术（TKA）的患者年龄超过65岁。除血栓形成倾向外，静脉曲张是THA和TKA术后发生静脉血栓栓塞（VTE）的最显著风险因素。本研究探讨老年骨科手术患者中预防性治疗大隐静脉功能不全的有效性。一项回顾性研究纳入了44例年龄超过65岁、接受TKA或THA的患者。24例患者接受传统手术，20例接受腔内激光治疗（EVLA）。明显静脉曲张和/或大隐静脉反流持续>500毫秒被视为手术指征。手术组和EVLA组均对可见静脉曲张及仅大隐静脉反流段进行了消融。
置换术后记录到1例有症状的深静脉血栓形成（DVT）。手术组和EVLA组之间的恢复时间存在统计学显著差异（p = 0.006）。手术组和EVLA组的长期复发率无统计学显著差异。
在治疗髋关节或膝关节之前安排大隐静脉手术是有益的。本研究表明术后DVT的发生率降低了50%。
