[Classical surgery versus 3-S saphenectomy in the treatment of lower extremity varices].
BACKGROUND
The rate of recurrence requiring redo surgery after primary surgical treatment of varicose veins is between 20 and 30%. Several techniques to reduce the high rate of recurrence after stripping have been designed over the years, especially reticulated recurrences at the sapheno-femoral junction. The aim of this study was to compare the recurrence rates of varices after treatment with two surgical techniques: stripping and 3-S saphenectomy.


METHODS
One hundred patients with leg varicose veins were randomly assigned to two groups. Group I consisted of 50 patients who underwent classical surgery (ligature and section at the sapheno-femoral junction and collateral veins, with saphenectomy). Group II consisted of 50 patients who underwent the 3-S saphenectomy technique (sclerosis injection at the sapheno-femoral junction with microfoam through a catheter, with saphenectomy and distal phlebectomies). The rate and type of recurrences were evaluated through echo-Doppler 12 months after the procedure.


RESULTS
Overall recurrence: group I: 78%, group II: 44% (P< .05). Trunk recurrence: group I 12%, group II 16% (P=NS). Collateral recurrence: group I 16%, group II 6% (P=NS). Perforator vein recurrence: group I 18%, group II 18% (P=NS). Reticulated recurrence: group I 32%, group II 4% (P=.002).


CONCLUSIONS
The 3-S saphenectomy technique decreases the overall rate of recurrence, particularly reticulated type recurrences. We recommend avoidance of surgery of the branches at the sapheno-femoral junction.
Arenas-Ricart
Javier
J
Servicio de Cirugía General, Hospital Arnau de Vilanova, Valencia, España.
Sellés-Dechent
Rafael
R
Ballester-Ibáñez
Cristina
C
Pérez-Monreal
Javier
J
González-Vila
Severino
S
Ruiz-del Castillo
Juan
J
D000328:Adult; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000601:surgery*; D015911:Sclerotherapy / Q000379:methods; D055502:Secondary Prevention; D014648:Varicose Veins / Q000188:drug therapy / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*