The place of surgery in the treatment of primary varices of the short saphenous vein.
Theories involving the therapy of primary varices of the short saphenous vein are still under discussion today. We try to define the place of surgery between two opposing points of view: that of the partisans of systematic short saphenectomy, and that of the partisans of sclerotherapy on its own. The authors have operated 1341 patients: --between 1961-1971: 968 underwent systematic short saphenectomy, --between 1971-1978: 373 patients underwent eclectic short saphenectomy. The results of the first series gave a 16% failure rate, in the second series there was a 2-3% failure rate. From which we raise the following points: 1. is systematic short saphenous excision always anodine? 2. the criteria for surgical indication to remember are: --clinical: incontinent dilated saphenofemoral junction, ampullary saphenofemoral junction, thick sclerous junction which has resisted sclerosis, saphenal trunk being related to the system of the long saphena; --radiological: wide-gauged saphenofemoral junction, reflux in full channel. Surgery will therefore be reserved for: --the short saphenous axes which are thick, hard, and difficult to sclerose, --wide-necked very ectasic saphenofemoral junctions, --short saphenal axes surrounded by sclerous atrophic cellulitis. From this we take our theory of "experimental" sclerotherapy, the failure of which is the only reason for adopting a surgical solution.
D006801:Humans; D012008:Recurrence; D012501:Saphenous Vein / Q000601:surgery; D012597:Sclerosing Solutions / Q000627:therapeutic use; D014648:Varicose Veins / Q000601:surgery*
D012597:Sclerosing Solutions