Residual stumps associated with inguinal varicose vein recurrences: a multicenter study.
OBJECTIVE
It is unclear whether a residual sapheno-femoral stump left in place after stripping of the great saphenous vein can contribute to the formation of late inguinal varicose vein recurrence. In order to obtain information about the time course of recurrence development, patients with histologically proven residual stumps were recruited and asked about the interval between the initial operation and the first clinical signs of varicose vein recurrence.


METHODS
A multi-centre study involving 7 centres was conducted amongst patients undergoing redo-surgery for inguinal varicose vein recurrences. The sapheno-femoral stumps resected during the redo-surgery were classified histologically. Patients with a proven long residual sapheno-femoral stump were asked to describe the first signs of varicose vein recurrence with the help of a standardised questionnaire. From these data the symptom-free interval, consisting of the time frame between the initial operation and the first signs of recurrence, was determined.


RESULTS
In 279 legs of 251 patients a long residual sapheno-femoral stump was present. Most patients had experienced a symptom-free interval after the initial operation with a mean duration of 7.4 S.D. 5.5 years. Recurrent varicose veins became apparent after a mean time interval of 6.3 S.D. 5.3 years and congestion symptoms occurred after a mean interval of 8.5 S.D. 5.7 years.


CONCLUSIONS
In patients with symptomatic groin recurrences, a long residual sapheno-femoral stump was found in about two thirds of cases. The first clinical signs of varicose vein recurrence can be expected 7-8 years after the initial treatment at the earliest. Long term follow up is required reliably to asses the outcome of treatment for varicose veins.
Department of Vascular Surgery, St. Josef-Hospital, Ruhr- University Bochum, Germany. Electronic address: bruno.geier@rub.de.
B
B
Geier
Department of Dermatology, St.Josef-Hospital, Ruhr-University Bochum, Germany.
M
M
Stücker
Department of Vascular Surgery, St. Josef-Hospital, Ruhr- University Bochum, Germany.
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T
Hummel
Praxis für Chirurgie und Phlebologie, Magdeburg, Germany.
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P
Burger
Mosel-Eifel-Klinik, Bad Bertrich, Germany.
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N
Frings
Praxis für Dermatologie und Phlebologie, Freiburg, Germany.
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M
Hartmann
Praxis für Dermatologie und Phlebologie, Saarlouis, Germany.
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D
Stenger
Praxis für Chirurgie und Phlebologie, Stade, Germany.
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C
Schwahn-Schreiber
Artemed Fachklinik, München, Germany.
M
M
Schonath
Department of Vascular Surgery, St. Josef-Hospital, Ruhr- University Bochum, Germany.
A
A
Mumme
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D005500:Follow-Up Studies; D005858:Germany; D006119:Groin / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012501:Saphenous Vein / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects