ORIGINAL ARTICLE   

Italian Journal of Vascular and Endovascular Surgery 2024 June;31(2):102-14

DOI: 10.23736/S1824-4777.24.01661-9

Copyright © 2024 EDIZIONI MINERVA MEDICA

lingua: Inglese

Surgical treatment of patients with acute ascending varicose thrombophlebitis of the lower extremities: single- vs. two-stage phlebectomy

Anastasia ASTAPENKO ¹ ✉, Yulia KOBAZOVA ², Elena SHCHUKINA ³, Nikita MATYUSHIN ^{4, 5}

¹ Department of General Medicine, Maykop State Technological University, Maykop, Russia; ² Department of Pedagogy and Methods of Primary Education, Nerungri Technical Institute, M.K. Ammosov North-Eastern Federal University, Nerungri, Russia; ³ Department of Psychiatry and Narcology, First Moscow State Medical I.M. Sechenov University, Moscow, Russia; ⁴ Department of Psychiatry and Narcology, First Moscow State Medical I.M. Sechenov University, Moscow, Russia; ⁵ Department of Nursing, First Moscow State Medical I.M. Sechenov University, Moscow, Russia

BACKGROUND: The number of people worldwide suffering from acute ascending varicothrombophlebitis of the lower extremities constitutes a significant patient group. The study aims to investigate the short-term and long-term consequences of using surgical methods of one-stage and two-stage phlebectomy in patients diagnosed with acute ascending varicothrombophlebitis of the lower extremities.
METHODS: The study was conducted from 2017 to 2022, involving 370 patients diagnosed with acute varicothrombophlebitis of the lower extremities. Group 1 comprised 246 patients who underwent two-stage phlebectomy, while Group 2 included 124 patients who underwent one-stage phlebectomy. Complications after surgery were analyzed, and comparisons were made regarding the duration of partial recovery of cutaneous hypoesthesia, along with an examination of differences in quality of life based on the CIVIQ 2 and SF-36 questionnaires.
RESULTS: Early postoperative complications were statistically more frequent among patients in Group 2: deep vein thrombosis (1% and 5%, P≤0.05), frequency of blood loss (1% and 7%, P≤0.05), subcutaneous nerve damage (14% and 28%, P≤0.05), and wound infection (4% and 21%, P≤0.01). Differences in the hypoesthesia indicator were observed, with Group 1 having lower values (P≤0.05). Quality of life, as assessed by questionnaires, was on average higher in patients from Group 1.
CONCLUSIONS: The results have practical significance for surgeons, assisting them in making informed decisions when choosing a surgical treatment method and providing information on the potential risks and benefits of each method.

KEY WORDS: Operative surgical procedures; Phlebotomy; Thrombophlebitis; Hypesthesia; Quality of life; Postoperative complications