[Combined therapy of lower limb variceal disease]

Complex surgical and medical therapy was used for 386 patients with lower limb variceal disease 2nd and 3rd form (segmental and disseminated varices with reflux through the superficial and perforant veins) and chronic venous insufficiency stage I (according to the Russian classification). Five main types of surgical interventions were fulfilled: combined phlebectomy, trunk scleroobliteration, short stripping with insufficient perforants ligation, short stripping with excision or damage of variceal influx, and short stripping with trunk scleroobliteration. Besides, vast majority of patients received venotonic drug Phlebodia 600 pre and postoperatively. Miniinvasive and atraumatic interventions were characterized by the decrease of postoperative subcutaneous hematomas, no incidence of n. saphenus damage and lymphorrhea, good cosmetic outcomes due to the absence of additional incisions. The duration of postoperative recovery correlated with intraoperative trauma and Phlebodia 600 administration. In conclusion, combination of complex surgical procedures and venotonic drugs can be widely used for the management of lower limb variceal disease, especially for its uncomplicated forms. While preserving the radicality, these interventions yield favorite esthetical results, reduce the time of postoperative recovery and disability, thus, appear to be cost effective.