MORPHOLOGICAL SUBSTANCE OF THE SELECTION OF OPTIMAL PARAMETERS OF ENDOVENOUS ELECTRIC WELDING FOR TREATMENT OF ASCENDING THROMBOPHLEBITIS OF GREAT SAPHENOUS VEIN

The aim of research is studying the morphological changes in thrombus vein after the usage of electric welding of high frequency and determination of the best operating modes for treatment of ascending thrombophlebitis of great saphenous vein. Material and methods: We have analyzed the re-sults of treatment of 42 patients, who had ascending throm-bophlebitis of great saphenous vein at the age from 25 to 69 years (average age is 44,7 ± 2.05 years). These patients were treated in surgical departments of city clinical hospital №8 of Kyiv during the period from 2015 to 2017. The parts of the scopes of thrombus great saphenous vein were cut during the surgical operation in order to determine the morphological structural changes in the vein wall before and after usage of endovenous electric welding. After the usage of endovenous electric welding the cut parts were divided into 4 groups depending on the exposure of endovenous electric welding: І group - an exposure of 5 seconds; ІІ - an exposure of 10 seconds, ІІІ- an exposure of 15 seconds, ІV – an exposure of 20 seconds. The microscopic study of colored cuts-off and their photo archiving were carried out using the light optical mi-croscopes «ZEISS» (Germany) with data processing system of «Axio Imager. A2». The statistical analysis of obtained results were car-ried out using the system of «STATISTICA 10 for Win-dows», (Copyright® StatSoft Inc. 1984-2011, USA, license № STA999K347156-W). The results of research: According to the per-formed morphological researches the depth of the structural changes while the impact of endovenous electric welding on the venous wall during the ascending thrombophlebitis of great saphenous vein depends on the mode of usage of endovenous electric welding. During the exposure for 5 seconds, the experts recorded the destructive changes mainly in endothelial and partly in the subendothelial layer of venous wall. With an increased exposure of 10 seconds, the destructive effect of electric current of high-frequency is more obvious and is characterized by the extension to the middle third of the muscular layer. During the exposure of 15 seconds, the destructive changes cover the outer third of the muscular layer involving adventitia. Due to this fact, all the layers of the venous wall merge into a single homogeneous complex. During the exposure of 20 seconds, the experts observed a complete destruction of adventitia and the involvement of surrounding venous tissues into destructive processes. The discussion of results: On the basis of obtained data of morphological researches it can be said without prej-udice that, the usage of endovenous electric welding in the mode of 5-10 seconds causes the incomplete destruction of the entire thrombus venous wall. Due to this fact, in clinical practice is can lead to complications or disease recurrence associated with the vein e-canalization. The usage of endove-nous electric welding during 15 seconds causes the complete destruction of entire venous wall without involvement of paravazal tissues in the process, while the usage for 20 se-conds causes the thermal damage to tissues surrounding the veins. Conclusions. The endovenous electric welding of high frequency of thrombus vein during the 15 seconds causes no thermal damages to the paravazal tissues. Also, it is optimal operating mode for treatment of ascending thrombophlebitis of great saphenous vein.