[Classical surgery versus 3-S saphenectomy in the treatment of lower extremity varices].

Abstract

INTRODUCTION:

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.

PATIENTS AND METHOD:

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.

• Authors: Javier Arenas-Ricart, Rafael Sellés-Dechent, Cristina Ballester-Ibáñez, Javier Pérez-Monreal, Severino González-Vila, Juan Ruiz-del Castillo
• Journal: Cirugia espanola (Cir Esp) Vol. 79 Issue 6 Pg. 370-4 (Jun 2006) ISSN: 0009-739X [Print] Spain
• Vernacular Title: Cirugía clásica frente a 3-S safenectomía para el tratamiento de las varices del miembro inferior.
• PMID: 16769002 (Publication Type: English Abstract, Journal Article, Randomized Controlled Trial)

Topics

• Adult
• Female
• Femoral Vein (surgery)
• Humans
• Lower Extremity (blood supply, surgery)
• Male
• Middle Aged
• Saphenous Vein (surgery)
• Sclerotherapy (methods)
• Secondary Prevention
• Varicose Veins (drug therapy, surgery)
• Vascular Surgical Procedures (methods)