N.S. ABUSHOV, E.J. ZAKIRJAYEV, Z.M. ALIYEV, G.N. ABUSHOVA

Scientific Centre of Surgery after M.A. Topchubashov, Baku, AZERBAIJAN

Introduction: In recent years the use of foamed sclerosants has become increasingly popular, largely because foam instillation confers several specific advantages in the treatment of lower limb varicose veins. Since foam displaces the intravascular blood and is not diluted in it such as occurs with liquid sclerosant injection, the concentration of the sclerosing agent in the vessel is known and controlled. The aim: estimation of efficacy of polidocanol (aethoxysklerol) endovenous foam sclerotherapy for complex surgical treating of lower limb varicose veins.

Material and methods: This report describes initial experience in surgical treating 42 patients with lower limb varicose veins. In basic group (20 patients) complex surgical treatment was performed by sapheno-femoral junction ligation, saphenectomy, distal phlebectomies and sclerosis of varicose veins, reticular and spider veins with foam form of 0.5%-3% polidocanol in intra- and. postoperative period. Foam was produced by the Tessari technique. Foam volumes varied from 1 to 16 mL for each treatment. Control group (22 patients) was performed by classic phlebectomy (sapheno-femoral junction ligation, saphenectomy, distal phlebectomies). Compression was used in all cases. Clinical improvement, patients' complaints and side-effects were determined after treatment.

Results: According to our data complete disappearance of varicose veins was determined in 94% of patients in the foam form group and and in 87% in the control group. In basic group no patient reported any major adverse effects, though there were four cases of transient skin pigmentation. There were more cases of cosmetic improvement and pain elimination in the foam form group (p<0,02). No pulmonary emboli or lung complications occurred.

Conclusion: We consider, that foam sclerotherapy is an effective and useful method for complex surgical treating of lower limb varicose veins.

COURSE OF DIFFUSE TOXIC GOITER IN MEN

R.A. AGAYEV, A.R. AGAYEVA, S.Y, YUSIFOV, J.B. MAMED-ZADE, S.N. AKHMEDOVA

Scientific center of Surgery named after M Topchubashov, Baku, AZERBAIJAN

According to various authors and our observations DTG is encountered much rarer in men than in women. One reason for the less susceptibility of males to thyroid diseases may be the role of the male sex hormone in the prevention of tireopaty, while the data on the effects of male hormones on thyroid function are scarce and contradictory. Course of DTG in men has its own characteristics. We set a goal to determine the peculiarity of the course and characteristics of preoperative preparation of men with DTG. 233 men, who were treated at the Department of Endocrine Surgery of SSC named after M Topchubashov were examined during the study. The age of patients ranged between 8 - 75 years, with average age 40 + -0.8 years. There were 17 patients with mild degree toxicity, 93 with mean and 123 patients suffered from severe toxemia. The degree of enlargement of the thyroid gland in men usually reached the 4^th – 5^th degree (in 121 (51.9%) and 88 (37.8%) persons, respectively). The control group included women with the same diagnosis (596), who were also treated at our clinic during the same period (2004-2005). According to our data, men were subjected to severe thyrotoxicosis more than women. The duration of the disease up to 1 year was encountered in men mainly with severe form of toxemia, whereas in women with mean degree of toxicity. In men with long-term DTG (4-6 years) severe toxemia was observed. Such as comorbidity: hypertonic disease, diabetes, were equally frequently observed in both groups. At the same time, 12% of men had gastric and duodenal ulcer in anamnesis, that was almost not observed in women. However, in 35.7% of cases in the latter, there was detected the associated form of reproductive system. The course of DTG in men is usually asymptomatic, with the development of a number of complications (cardiovascular, ocular, sexual) in the “debut” of the disease. On the background of thyrotoxicosis in 47.8% of cases, there occurred certain sexual dysfunctions (decreased libido, potency). In the overwhelming majority of men (79.9%) there was observed significant (p <0.05%) reduction in the level of testosterone by an average of 32.2% as compared to the control group. In absolute terms this figure was 4.6 + -0 , 47 nmol/liter. So, DTG in men has several features: forms at young age, is characterized by the rapid course, severe toxicity, large sizes, the decrease in testosterone levels and oestrogenization of body, severe toxemia is 2.2 times more than women combined with the development of endocrine ophthalmopathy.

Date: 2014-12-28; view: 727