Operation Troyanov-Trendelenburg - what is it?

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2018-03-19 17:24:13

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In recent years, varicose veins tend to rejuvenation. Every third woman has a disease still of working age. Among men suffer one-tenth. The development of thrombosis or thrombophlebitis - a dangerous complication of venous pathology. In this case, you will have to use crossectomy (operation Troyanov-Trendelenburg).

Varicose veins

Varicose veins called disease is accompanied by persistent changes in the vascular wall, expansion and elongation of the vessels with the formation of protrusions, knots, and further circulatory problems.

Venous network of the lower limbs submitted to surface and deep vessels communicating with each other. The superficial system comprises the great and small saphenous veins. Big starts in the groin and into the upper part of the thigh, falling into a deep femoral vein.

surgery Troyanova Trendelenburg

Varicose veins are accompanied by changes in intravascular pressure, slowing of blood flow, stagnant processes. The vessels are dilated, overfilled with blood. The valve system veins no longer cope with its task to regulate one-way blood flow, opens the way to the formation of a reflux of blood (backward throw). It is often in these situations the clinical picture of the disease is in full swing that makes contact the patient to vascular surgeon.

A Common choice as operation Troyanov-Trendelenburg. What it is, how it's performed and what the result of intervention, will be discussed further.

The Purpose of crossectomy

Before a specialist is the main task - to get rid of the reflux and eliminate stagnant processes in the varicose changed veins. So as to stop the circulation with the help of medication is not possible, then the only way is getting the intersection of diseased vessels and their tributaries.

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Crossectomy (operation Troyanova-Trendelenburg) is considered radical surgery. It is performed in case of complications of varicose veins (eg, phlebitis or thrombosis) or as an element of comprehensive treatment.

Difference from crossectomy phlebectomy

More recently, phlebectomy (venectomy) was considered an excellent option for the treatment of varicose veins. It is performed under spinal anesthesia in a hospital. The operation was characterized by high invasiveness and the development of postoperative complications. Soon the results of phlebectomy began to show that it is necessary to find a more radical method to reduce the possibility of recurrence of the disease.

Venektomiya was accompanied by the crossing of the great saphenous vein in the upper thigh, not near the anastomosis, which led to the resumption of reflux in the tributaries safely about anastomosis. Disease recurrence occurred in every third patient.

surgery Troyanova Trendelenburg technique

The Modernization of crossectomy based on the fact that the cut and the intersection are near the confluence of the deep femoral vein, resulting in occurs blood reflux in the deep system.

Indications for intervention

Operation Troyanov-Trendelenburg carried out urgently in the first days after the formation of the thrombosis to stop the transition of pathological process from a superficial vein in the deep system.

The Indications for intervention are as follows:

  • Arthritis from knee level and above;
  • Thrombophlebitis complicated by development of purulent processes;
  • Recurrent thrombophlebitis or one that does not respond to other therapies;
  • Thrombosis from knee level and above.

Contraindications

It is Important to understand that the operation Troyanov-Trendelenburg, indications of which are emergency, not considering the presence of contraindications. In this case we are talking about the life of the patient.

surgery Troyanova Trendelenburg evidence

With a planned intervention specialists identified a number of factors when the operation is junk:

  1. Physical illness - the patient's body is severely weakened, and any operation requires a lot of effort to recover. In such case it is necessary to use a less radical methods of treatment.
  2. Atherosclerosis of the lower limbs severe.
  3. Pregnancy or lactation.
  4. The Presence of infectious diseases or purulent lesions in the site of the proposed intervention.
  5. A Condition in which it is impossible to carry out a good compression of the legs after surgery (severe obesity).
  6. Thrombophlebitis or deep vein thrombosis.

Operation Troyanov-Trendelenburg requires quick activation of the patient after the intervention, so the pathology in which the patient will not be able to get out of bed on the second day, are considered individually.

Preparing for surgery

As in most cases the patient is admitted urgently to perform the intervention, and examinations are held at the required minimum:

  • General blood and urine tests;
  • Biochemistry of blood;
  • Coagulation;
  • Study on syphilis, hepatitis;
  • Screening for HIV infection.

The Therapist conducts a consultation to rule out the presence of systemic diseases, which would be a contraindication. Also ultrasound scanning of the veins to determine the localization of the anastomoses, the location of diseased vessels, the prevalence ofthe pathological process.

surgery Troyanova Trendelenburg description

After taking the necessary measurements, a vascular surgeon explains what compression stockings or elastic bandage must be purchased to perform the compression of the extremities immediately after surgery.

Operation

Operation Troyanov-Trendelenburg, a technique which requires high qualification of the surgeon, is carried out using local or General anesthesia. The choice of anesthesia, does the anesthesiologist, agreeing all the nuances directly with the patient.

Operation Troyanov-Trendelenburg described in the article consists of the following steps:

  1. The operative field is treated with antiseptic solutions should be applied with sterile linen, space for access.
  2. In the groin area, the surgeon probes the pulse of the femoral artery, which passes inwards and a little saphenous vein.
  3. Anatomical features of all patients varied, and hence the location of the veins is different. The incision is made depending on the localization of the anastomosis of the great saphenous vein.
  4. After the cut, the surgeon gets to the venous beam, and bandaging his cuts.
  5. Stands the great saphenous vein to the area where it empties into the deep system, tied off and clipped. At this point, the blood can get blood clots.
  6. Next, in the same way are identified and clipped at least five tributaries of the vein along its length (if necessary make some additional cuts). This is to prevent reverse blood collection and disease recurrence.
  7. All the cuts are sewn with a put drainages.
  8. Lower limb wearing a compression garment or elastic bandage.

surgery Troyanova Trendelenburg

Operation Troyanov-Trendelenburg position is associated with inflammatory processes and formation of blood clots, so in case of emergency, the experts do not try to remove as much of the veins, and the maximum cropped area of the pathological process.

Postoperative period

The First day the patient spends in bed. This is due to the possible side effects after anesthesia. On the second day shown activation of the patient, to best protect it from re-thrombosis. The pain is moderate, but if necessary, the doctor prescribes painkillers or non-steroidal anti-inflammatory drugs.

A prerequisite is adequate compression of the lower extremities, which is held over the months after the intervention.

Should pay attention to the actions directed on prevention of stagnant processes in the system of veins (Hiking, physical therapy).

surgery Troyanova Trendelenburg operation

Possible complications after surgery

Operation Troyanov-Trendelenburg, complications which are extremely rare, refers to the radical methods of treatment. Frequent cause of complications are tissue trauma during the intervention (what to avoid), as well as a violation of surgical technique. The patient may develop the following pathology:

  • Bleeding;
  • Hematoma in the area of intervention;
  • Wound infection;
  • Disorders of the lymphatic system with the formation of cystic conglomerates;
  • Paresthesia (disturbance of skin sensation at the intersection of nerve endings);
  • Lymphorrhea (lymph expiration of the intersection of lymphatic vessels).

Some of the complications are on their own, others need additional therapy. Hematoma in severe cases, subject to puncturing with further antibiotic therapy. Wound infection also requires the use of antibiotics (penicillins, macrolides, cephalosporins). Broken sensitivity is restored independently, does not require additional measures.

surgery Troyanova Trendelenburg complications

Conclusion

One of the radical methods of complex treatment of varicose veins and its complications is the operation Troyanov-Trendelenburg. The operation shows how modernized the system by eliminating reflux and prevention of relapses. Compliance with the councils operating specialist will allow you to avoid the need for repeated interventions.


Article in other languages:

AR: https://tostpost.com/ar/health/10880-troyanov.html

BE: https://tostpost.com/be/zdaro-e/19494-aperacyya-troyanova-trendelenburga---shto-geta-takoe.html

DE: https://tostpost.com/de/gesundheit/19503-die-operation-trojanow-trendelenburg---was-ist-das.html

ES: https://tostpost.com/es/la-salud/19513-la-operaci-n-de-troyanova-trendelenburg---qu-es.html

HI: https://tostpost.com/hi/health/10890-troyanov-trendelenburg.html

JA: https://tostpost.com/ja/health/10891-troyanov.html

KK: https://tostpost.com/kk/densauly/19489-operaciya-troyanova-trendelenburga---b-l-ne.html

PL: https://tostpost.com/pl/zdrowie/19455-operacja-troyanova-trendelenburga---co-to-jest.html

PT: https://tostpost.com/pt/sa-de/19461-a-opera-o-troyanova-trendelenburga---o-que.html

TR: https://tostpost.com/tr/sa-l-k/19496-operasyon-troyanova-trendelenburg---bu-nedir.html

UK: https://tostpost.com/uk/zdorov-ya/19486-operac-ya-troyanova-trendelenburga---scho-ce-take.html

ZH: https://tostpost.com/zh/health/11700-troyanov.html






Alin Trodden - author of the article, editor
"Hi, I'm Alin Trodden. I write texts, read books, and look for impressions. And I'm not bad at telling you about it. I am always happy to participate in interesting projects."

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