IntroductionLymphorrhea due to classical and mini-invasive surgical interventions on femoral and popliteal arteries is a serious hindrance to patient treatment. Depending on the experience of a particular center, the incidence and frequency of this type of complication may constitute a serious clinical problem. While the level of lymphorrhea intensity and its duration result in certain foreseeable consequences, their treatment can be a time-consuming and multistep procedure.AimTo compare different types of vascular interventions with lymphorrhea occurrence.Material and methodsThe authors conducted a retrospective analysis of lymphatic complications based on the material collected between 2005 and 2012 at the Department of Vascular and Endovascular Surgery of the Military Institute of Medicine in Warsaw and in the Department of Interventional Cardiology and Angiology of the Institute of Cardiology in Anin, Warsaw, in 2009–2012.ResultsMaintaining due thoroughness when dissecting tissues and treating the cutting line in this area with ligatures and tissue puncture are the most reliable methods of minimizing the risk of lymphatic leakage after surgical procedures performed in a classical way. The lymphatic complication under analysis is far less likely to occur when procedures are performed as planned and an endovascular technique is used – statistical significance p < 0.05. Minimally invasive and fully percutaneous procedures performed via needle puncture, including the use of the fascial closure technique to close the femoral artery, eliminate the likelihood of the occurrence of this vascular complication – statistical significance was found with p value less than 0.05.ConclusionsWe concluded that in every case by minimizing the vascular approach we protected the patient against lymphatic complications.
Patient: Female, 61-year-old Final Diagnosis: Leiomyosarcoma Symptoms: Pain • redness • tenderness • warmth Medication: — Clinical Procedure: Excision of tumor Specialty: Surgery Objective: Unusual clinical course Background: Leiomyosarcoma is a common tumor found in soft tissue. In relation to the vascular system, leiomyosarcoma appears as the most common malignancy characterized by poor prognosis. Leiomyosarcomas of the leg large vessels often occur late, and their appearance can imitate vein thrombosis with symptoms such as soft tissue swelling or mild pain, and can be misdiagnosed. Peripheral vascular leiomyosarcomas are rare. Especially leiomyosarcomas of the great saphenous vein are uncommon. The tumors develop on the media basis and grow from endovascular to exovascular order. Distant metastasis can be identified and worsen prognosis. Case Report: We present a case of a 61-year-old female patient with varicose vein disease complicated by recurrent superficial vein thrombosis. After 2 months of conservative treatment, while waiting for admission to the department of surgery, she developed additional symptoms. Clinical examination on the day of admission revealed several tumors along and near the great saphenous vein on the left limb below the knee. The diagnosis of leiomyosarcoma was confirmed after the surgery, involving excision of the saphenous vein, including tumors formed on its course. Preoperative clinical and ultrasound findings did not suggest malignancy. Conclusions: Leiomyosarcoma of the great saphenous vein is an extraordinarily rare tumor originating from the middle layer of the vessel, mimicking unspecific symptoms and complicating and delaying diagnosis. In every case of vascular or perivascular lesions, a detailed examination and diagnosis it is required, and even unlikely clinical scenarios should be considered.
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