ORIGINAL ARTICLES   

Chirurgia 2000 June;13(3):151-4

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Recurrent varicose veins of the lower limbs after saphenectomy by stripping

Botta G., Delle Monache G., Belcastro M., Piccinetti A., Mancini S.

Background. To refer personal experience on the causes and treatment of patients with lower limb recurrent varicose veins after saphenectomy by stripping.
Methods. The retrospective study has been conducted on 104 patients (81 female and 23 male) with recurrent varicose veins, observed by the authors at the Phlebolymphology Center of the University of Siena from January 1994 to December 1998. The most frequent causes of recurrence have been surgical technique errors in 77 patients (74%), such as incomplete resection of one or more periostial collateral veins (28), recanalization of the great saphenous vein after ligation with associated sclerosis of the saphenous trunk (22), long saphenous stump (18), refluxing saphenofemoral junction left in place (9), and diagnostic errors in 27 patients (26%) due to unidentified incompetent perforating veins.
Seventy-seven patients underwent revision of the saphenofemoral junction, while the remaining 27 underwent ligation and section of the refluxing perforators, along with multiple phlebectomies according to Müller's technique.
Results. At clinical follow-up, varying from several months to five years, results have been excellent in 91% and good in 9% of cases, with disappearance of patients' subjective symptomatology.
Conclusions. In order to reduce the incidence of recurrent varicose veins, it is necessary to pay the closest possible attention in the preoperative clinical and instrumental evaluation of the varicose patient. It is furthermore essential to pose the exact indication to surgical therapy, which must be executed with a flawless technique.