[Causes of recurrencies following procedures for varicose veins of the lower extremities].
OBJECTIVE
The aim of the study is to analyze causative factors of recurrencies following varicose veins procedures, and to propose procedures aimed at reduction of the relapse rates.


METHODS
During the period of 1993-2005, 2034 extremities in 1756 patients were operated. 24% of the cases were reoperations, 85% of the operated were sclerotized pre- or post-operatively. Total anaesthesia was used in 1350 subjects, 406 patients underwent procedures under local anaesthesia. Complete crossectomy was completed, mostly including invagination stripping of the femoral part of the VSM. When necessary, the saphenopopliteal junction and perforators were resected.


RESULTS
No deaths were recorded. The complication rate was 3.8%, all were managed without hospitalization and included the wounds healing complications. 91% of patients were discharged on the day of the procedure. Over 50% of patients were not out of work. 420 procedures were reoperations (24%). None or incomplete crossectomy was analyzed as the relaps cause in 65% of the cases. None or misconduct resection of the saphenopopliteal junction and perforators resulted in relapses in 35% of the cases. In all cases, it could be concluded, that badly managed, or not at all managed, reflux was the cause of the reoperations. Following completion or either primary operation or reoperation by our team, 404 operated were lost from our evidence, 1352 patients were followed up regulary. 16 patients (1.2%) were indicated for another surgical procedure, 14 of them were indicated for the saphenopopliteal junction incompetence and 2 for its reincompetence. No new reflux in the groin region was recorded.


CONCLUSIONS
Badly managed, or not at all managed, saphenofemoral or saphenopopliteal reflux was the cause of significant recurrencies resulting in reoperations. Neoanginogenesis was not recorded and the authors refuse to accept it as a cause of the relapses of the varicose veins. Exact diagnosis, correct indication and sufficient radicality of the procedure prevent recurrencies of the disorder.
Bartos
J
J
Ambulance cévní chirurgie Nový Bor. jiribartosacch@centrum.cz
Bartos
J
J
D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation; D014648:Varicose Veins / Q000601:surgery*