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This paper describes the results of tissue pressure measurement according to the Emmet technique in the subcutaneous fat at phlebogenic edema in 31 patients with lower extremity varicosity. The changes in the pressure were recorded over a length of 5-10 after needle impaction. The rate of tissue fluid resorption was measured. The indicators appeared normal in 16% of patients, absorption was accelerated in 39%, and deceleration of absorption was marked in 45% of patients. In the event of decelerated resorption, chronic edema was observed more frequently. The rate of saline resorption in health exceeded 4.8-fold the rate of tissue fluid absorption. In valvular insufficiency of the deep veins, this indicator is up to 4.8-fold as increased. Cessation of tissue fluid and/or saline resorption points to tissue swelling at the microcirculatory level. The given technique allows to diagnose latent edema, to objectively evaluate the patient tissue response to a specific drug and elastic appliance, to work out the well-founded indications for phlebectomy, especially in young people. Also, it enables the assessment of the results of surgical intervention and making the early diagnosis of disease recurrences.

The author suggests a new modification of operation for formation of subfascial lymphovenous anastomoses (LVA) on the dorsum of the foot in treatment of edema of the lower limbs. Sixty-two patients underwent operation. In 34 patients of the control group an epifascial LVA was formed on the dorsal surface of the foot. The operation for LVA anastomosis was combined with fenestration of the leg fascia. A positive effect of various degree was produced in the postthrombotic syndrome in 84% of the studied patients (in 29% of the controls) and in 94% of cases of II degree lymphedema (in 56% of the controls). The expediency of subfascial LVA is substantiated clinically and physiologically.

The authors came to the conclusion that in surgical treatment of the postthrombophlebitic syndrome it is necessary in some cases to excise the indurated fatty tissue on the leg during the operation on the veins. It should be carried out transfascially through a Felder incision in combination with ligatin of the perforating veins on the leg. The suggested method produces better results than those of excision of the changed fatty tissue through a cut made in the skin overlying it. Excision of the indurated fatty tissue removes the focus of chronic infection and autoallergy.

Operations were conducted on 41 patients, 31 of them had a primary form of lymphedema. Lymphovenous anastomoses (LVA) were formed in the region of the medial collector on the thigh in Scarpa's triangle, in the middle third of the leg, and on the dorsum of the foot. The results were good in the late-term postoperative period in 74.0% of patients. According to earlier studies, the formation of LVA in patients with primary lymphedema of the lower limbs only on one of the standard levels produces good late-term postoperative results in 57.8% of cases.

The authors examined 152 patients with lymphedema of the lower limbs 2-6 years after operation for lymphovenous anastomoses (LVA). They evaluated the dynamics of edema according to Alberton's formula, the changes in the character of the episodes of erysipelas, and the patient's feeling of heaviness in the involved limb. The function of the anastomosis was studied by the radioisotope method. Positive results were recorded in 99 patients. In the remaining patients the LVA did not function and the symptoms of lymphedema did not change or progressed. The effect of LVA was found to be positive in 51 patients in the group of 69 patients with secondary form of lymphedema and in 48 of 83 patients with the primary form of the disease. The last-mentioned was connected with congenital insufficiency of lymph drainage. The condition of the collecting lymphatics is an important factor of LVA efficacy: the effect of LVA was positive in 68 patients in hyperplasia and in 31 patients in hypoplasia of the lymphatics. The results of LVA are improved by regular nonoperative management for the correction of endocrine-immunological and hemostatic factors as well as by stimulation of lymph drainage in the limb and prevention of inflammatory complications.

Seven free grafts of an anterior wall of common bile duct with autovenous patches were realized using microsurgical technique in 7 dogs. Carcass and cavity drainage were not used. It was shown that one month after the operation the interior surface of the patch was covered with normal duct mucosa and the duct was not dilated. No inflammatory and macrophage reactions were observed in the patch or surrounding tissue.