Service comparison between vascular and general surgery in the treatment of chronic venous insufficiency with special reference to preoperative Doppler techniques.
OBJECTIVE
To compare the ability of vascular and general surgical services to abolish reflux in superficial venous system with a special reference to preoperative use of Doppler techniques.


METHODS
68 lower limbs operated on for venous insufficiency based on either preoperative Duplex evaluation and Doppler marking in a vascular surgical unit (Vascular Surgical Service, VSS: 33 limbs, clinical class C2-C6) or clinical findings in a general surgical unit (General Surgical Service, GSS: 35 limbs, clinical class C2-C4) were re-examined clinically and with duplex scanning for reflux some three years postoperatively.


RESULTS
Marked superficial or perforator vein reflux was observed in 27 of 68 (39.7 %) operated limbs, thirteen of which in VSS and fourteen in GSS. However, axial reflux at saphenofemoral or thigh level was observed significantly less in VSS compared to GSS (3 vs 13, p = 0,006).


CONCLUSIONS
Total ablation of any reflux appeared difficult irrespective of the preoperative assessment. Preoperative Duplex examination, however, aided in identifying and treating axial reflux at thigh level.
Department of Vascular Surgery, Helsinki University Central Hospital, Finland. annamari.oinonen@helsinki.fi
A
A
Oinonen
N
N
Sugano
A
A
Lehtola
N
N
Suokas
U
U
Keränen
M
M
Lepäntalo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012008:Recurrence; D013043:Specialties, Surgical; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*