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2010, Número 6

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Cir Cir 2010; 78 (6)


Cirugía venosa de mínima invasión

Gómez-Palacio VM, Águila-Márquez R

Idioma: Español
Referencias bibliográficas: 53
Paginas: 500-507
Archivo PDF: 317.56 Kb.


RESUMEN

Introducción: El tratamiento quirúrgico de las várices primarias de los miembros inferiores cuenta en la actualidad con nuevas alternativas de mínima invasión. Objetivo: determinar la eficacia, seguridad y la recuperación posoperatoria con ablación térmica de la vena safena interna (radiofrecuencia) asociada con miniflebectomía o escleroterapia de venas comunicantes y de telangiectasias.
Material y métodos: Del 6 de noviembre de 2006 al 15 de diciembre de 2009 se trataron 204 extremidades inferiores en 102 enfermos con várices primarias: 74 mujeres y 28 hombres, con un promedio de edad de 38 ± 6 años. Por ultrasonido Doppler se determinó en el preoperatorio la permeabilidad, competencia de los sistemas venosos profundos, la localización de los sitios de reflujo y el diámetro de las venas safenas. En el posoperatorio se realizaron controles ultrasonográficos a las 72 horas, seis meses y 12 meses.
Resultados: A los 12 meses, 98% de las venas tratadas mostraba cierre permanente, hubo dos recurrencias (1.98%) a los seis y 10 meses, asociadas con recanalización de la vena. No existieron complicaciones sistémicas; en un caso hubo quemadura cutánea que requirió debridación, posiblemente por perforación venosa con la punta del catéter. La recuperación posoperatoria promedio fue de 1.14 días.
Conclusiones: La combinación de radiofrecuencia, miniflebectomía y escleroterapia con espuma constituye una alternativa eficaz, segura y con rápida recuperación posoperatoria en el tratamiento de las várices primarias de los miembros inferiores.


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