Recurrent varicose veins of the lower limbs after surgery. Role of surgical technique (stripping vs. CHIVA) and surgeon's experience.
BACKGROUND
Surgical treatment of varicose veins of the lower limbs resolves symptoms and improves quality of life. However, the high recurrence (20-80%) is a costly and complex issue.


METHODS
This is a retrospective review of 1489 patients with varicose vein of the lower limbs seen at our hospital between January 1980 and December 2005. The aim is to evaluate the effect of surgical technique (stripping vs. CHIVA) and surgeon's experience in reducing recurrences.


RESULTS
With experienced surgeons, CHIVA appears to be more effective than stripping in reducing the recurrence rate (p <0.05). However, when performed by an inexperienced surgeon the results are far worse than those achieved with stripping.


CONCLUSIONS
There was a clear reduction in recurrences at 5-10 years with CHIVA than with conventional stripping. However, if performed incorrectly, results are far worse with CHIVA. In fact, good results are far more difficult to achieve with CHIVA than with stripping, which is repeatable and easy to perform.
Department of Surgery, University of Naples, Naples, Italy.
M
M
Milone
G
G
Salvatore
P
P
Maietta
L M
LM
Sosa Fernandez
F
F
Milone
D005500:Follow-Up Studies; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D059348:Peripheral Nerve Injuries / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods