Obesity and chronic venous diseases as comorbid pathologies in surgical practice

This review is devoted to the modern view of morbid obesity in the development and treatment of chronic venous diseases (CVD) and includes a compilation of data from domestic and foreign literature, including clinical recommendations of WHO and the Russian Ministry of Health. Currently, there is evidence of an aggravating association of morbid obesity (BMI ≥ 40 kg/m 2 or with BMI ≥ 35 kg/m 2 in the presence of serious complications associated with obesity) with CVD, while both conditions are widespread in the world with a tendency to progress. Often they exist simultaneously in the patient, which increases the risk of vascular events and radically changes the management tactics of such a patient. The outcomes of developing remodeling in the walls of the veins in the form of, first of all, an inflammatory process are reflected in the arterial bed, which increases the relevance of the issue and emphasizes the need for timely correction and, mainly, adequate surgical treatment. The results of various surgical interventions at venous incompetence worsen along with an increase in BMI. In this regard, today, patients with extremely (≥40 kg/m 2 ) high BMI are primarily recommended to treat not venous insufficiency, but to correct weight, including through bariatric surgery, which is due to the ineffectiveness of the reverse approach.