Background: An invasive phlebological treatment is still not free from complications such as thrombosis. As in other surgical populations, not only the treatment modality, but also patient condition-related venous thromboembolism (VTE) risk factors matter. The current protocols used in varicose vein surgery centers are based mostly on individual risk assessment as well as on an implementation and extrapolation of general surgery VTE prophylaxis guidelines. In the presented study, the efficacy of routine VTE pharmacological thromboprophylaxis in patients undergoing saphenous varicose vein surgery was prospectively evaluated. In the result assessment, VTE risk factor evaluation and Caprini score results were included; however, due to the limited size of the projected study group, as well as expected limited deep vein thrombosis (DVT) prevalence in this clinical scenario, it was not possible to perform the validation of the Caprini model efficacy in the projected study model. Methods: In the study, 141 patients undergoing saphenous vein stripping and miniphlebectomy in spinal anesthesia were included. In all of the patients, VTE risk factors (including Caprini score evaluation) were assessed, and the routine thromboprophylaxis with enoxaparin 40 mg for 10 days was used. The venous ultrasounds were undertaken before the surgery and on the 10th and 30th day after surgery. The study endpoint was the presence of symptomatic or asymptomatic DVT confirmed in the imaging study. The study safety endpoint was major bleeding occurrence intraoperatively or within 30 days after surgery. Results: The presence of a postoperative DVT was diagnosed in five cases (3.5%) In all of these cases, only distal DVT was confirmed. Despite extensive saphenous varicose vein surgery with stripping and miniphlebectomy performed in nontumescent but spinal anesthesia, no proximal lower leg episode was diagnosed. Three out of five DVT cases were diagnosed on day 10 postoperative control, while a further two were confirmed in the ultrasound examination performed 30 days after procedure. No clinically documented pulmonaly embolism (PE) as well as no bleeding episodes were noticed. Among the factors related to the statistically significant higher DVT occurrence, the results of the Caprini score were identified with odds ratio (OR) = 2.04 (95% CI = (0.998; 4.18)). Another factor that became statistically significant in terms of the higher postoperative DVT prevalence was the reported Venous Clinical Severity Score (VCSS) results (OR = 1.98; 95% CI (1.19; 3.26)). In the multiple logistic regression analysis, the patient age (OR = 0.86; 95% CI (0.75–0.99)), Caprini score evaluation results (OR = 4.04; 95% CI (1.26–12.9)) and VCSS results (OR = 2.4; 95% CI (1.23–4.7)) were of statistical significance as predictors for postoperative DVT occurrence, with a p value of 0.029 for age, and p = 0.017 and p = 0.009 for Caprini score results and VCSS results, respectively. Due to the confirmed limited number of the DVT events in our study cohort, as well as the descriptive and explorative nature of the achieved results, the final clinical potential and significance of the identified parameters, including Caprini score rate and VCSS rate, should be interpreted with caution and studied in the further trials in these clinical settings. Conclusion: All the patients undergoing varicose vein surgery should undergo VTE risk evaluation based on the individual assessment. In VTE risk evaluation, patient and surgical procedure characteristics based on the factors included into the Caprini score but also on specific chronic venous disease-related factors should be taken into consideration. Further studies are needed to propose an objective and validated VTE risk assessment model, as well as a validated antithrombotic prophylaxis protocol in this particular patient group.

Objectives: Venous thromboembolism (VTE) is one of the most common causes of death associated with cardiovascular diseases. Despite the relatively high incidence rate, awareness and access to information about VTE risk factors as well as knowledge concerning effective prevention possibilities remain limited, including among health care professionals. The aim of the study was to assess the knowledge and awareness concerning venous thromboembolism among students of the Medical University of Silesia. Material and methods: The study was performed on a group of 400 medical students from the Medical University of Silesia in Katowice from years 3 to 6, recruiting 100 people from each of the clinical years. The study was conducted based on a survey which included 27 questions concerning knowledge of the definition of venous thromboembolism, pathogenesis, epidemiology, risk factors, symptoms and diagnostics related to this group of patients. Results: The proper definition of venous thromboembolism was indicated by 60% of the respondents and the proper components of Virchow's triad, which underlies the pathogenesis of deep vein thrombosis, were defined by 69%. The further question answers revealed that although the study programme includes venous thromboembolism, the knowledge of the students in the field of epidemiology, symptomatology and risk factors of this affliction is still limited. Conclusions: According to the results of the study, it is advisable to take action, including educative effort, to increase the awareness of the future medical staff about problems related to VTE.

Right hemicolectomy (RH) is a common procedure for both benign and malignant colic disease. Different anastomotic types are performed during this procedure. To assess the association between anastomotic type and postoperative complications (PC) in patients undergoing RH. Retrospective analysis of medical records of 72 patients (39 female and 33 male), aged 24 to 93, undergoing open RH in the Department of Gastrointestinal Surgery. Data regarding anastomotic type [end-to-end anastomosis, side-to-side (SSA), end-to-side anastomosis, and side-to-end anastomosis (SEA)], and different clinical factors were collected. There were 21 (29%) end-to-end anastomosis, 25 (35%) SSA, 15 (21%) end-to-side anastomosis, and 11 (15%) SEA in the analyzed group. Adenocarcinoma G2 was the most frequent indication for RH - 30 (42%). Total duration of hospitalization (in days) was the longest (14, 26) after SEA and the shortest (12, 68) after SSA. PC were noted in 17(24%) patients. Wound infection was the most common complication noted in 15(21%) patients. The overall anastomotic leak rate was 7% (5/72). PC were the most frequent after SEA noted in 64% (7/11) including abdominal bleeding and bowel perforation. The overall reoperations rate was 6% (4/72). The overall mortality rate was 4% (3/72). SEA was associated with the highest incidence of postoperative complication however based on this and other studies there are no satisfying conclusions regarding the best choice of anastomosis.

Chronic venous disease (CVD) is a progressive condition that affects a significant percentage of the population. Clinical manifestation of CVD differs between the patients: from asymptomatic patients with esthetic problems only to the very severe stages (including venous leg ulcer) that significantly decrease the quality of life (Qol). Although the varicose vein patients can be asymptomatic and they decide for treatment only for cosmetic reasons, many of them present the symptoms and/or signs of CVD, including pain, heaviness, itching, cramps, swelling, trophic changes or ulcerations. Therapeutic management of varicose veins includes surgery, minimally invasive procedures (involving saphenous ablation or sclerotherapy), compression therapy and pharmacological treatment. Traditional surgical treatment has been a leading method in invasive VV management for many years. Nonetheless, minimally invasive treatment thrived in the 21st century and overtook open surgery regarding VVS and more advanced stages of CVD. Another commonly used minimally invasive method in the treatment of VV is foam sclerotherapy. The efficacy of EVLA in the treatment of VV can be improved by performing adjunctive foam sclerotherapy (FS) of the tributaries. The combination of EVLA and FS is an effective method of reducing the rate of reinterventions in VV patients with saphenous vein incompetence. In the patients undergoing saphenous ablation, VV treatment (FS or mini phlebectomy) can be performed within the same procedure or as the delayed treatment. The argument for delayed treatment is the potential possibility of the VV regression (partial or complete) after saphenous vein ablation. On the other hand, saphenous ablation and varicose vein treatment within the same session result in fast and complete varicose vein removal without the need for additional procedures. Nevertheless, there is no consensus regarding the optimal timing of performing FS after EVLA of the GSV trunk and because of many diversified scientific reports there are still different approaches to this problem in phlebological centres around the world. Since the timing of adjunctive FS after EVLA procedure in the treatment of VV associated with GSV incompetence is a topic of open debate among surgeons, this study is a review that compares concomitant and staged treatments of VV.

WstępOgólnoświatowy ruch samolotowy osiąga rocznie liczbę 2,3 miliarda pasażerów. Powikłaniem długich lotów samolotem jest żylna choroba zakrzepowo-zatorowa (<i>venous thromboembolism</i> – VTE). Obejmuje ona zakrzepicę żył głębokich (<i>deep vein thrombosis</i> – DVT) i zatorowość płucną (<i>pulmonary embolism</i> – PE). Pomimo stosunkowo dużej częstości występowania tej choroby dostęp do informacji na temat czynników ryzyka oraz prewencji VTE jest ograniczony, co może wynikać ze zbyt małej liczby ogólnodostępnych artykułów dotyczących problemu, jak również z niedostatecznej uwagi poświęcanej tej jednostce chorobowej przez wykładowców i lekarzy. W pracy podjęto próbę oceny świadomości i wiedzy studentów medycyny na temat powikłań zakrzepowych związanych z długotrwałymi lotami samolotem.Materiał i metodyBadanie przeprowadzono między 10 listopada 2017 r. a 28 lutego 2018 r. w grupie 100 studentów medycyny Śląskiego Uniwersytetu Medycznego w Katowicach. Do badania wykorzystano kwestionariusz ankiety, który zawierał 12 pytań dotyczących wiedzy na temat występowania i patogenezy VTE związanej z długotrwałymi lotami samolotem. Uczestnicy badania opierali swoje odpowiedzi na wiedzy zdobytej podczas nauki na uniwersytecie.WynikiPrawidłowo częstość występowania VTE związanej z lotami samolotem wskazało 43% ankietowanych. Żaden ze studentów nie wskazał poprawnie czynników ryzyka VTE. Spośród badanych 40% znało patogenezę VTE w wyniku długotrwałych lotów. Zadowalający jest fakt, że 100% ankietowanych wiedziało, że odpowiedni ubiór może redukować ryzyko VTE podczas lotów samolotem.WnioskiAnkieta wykazała niski poziom wiedzy, jak również świadomości studentów związanej z zagrożeniem VTE podczas lotów samolotem. Wyniki badania powinny zostać uwzględnione podczas planowania na studiach medycznych zajęć dotyczących problematyki VTE.