A RELAPSE, OR CONTINUATION OF VARICOSE DISEASE – THAT IS THE QUESTION?

A.V. Gavrilenko, P.E. Vakhratyan
Russian Scientific Centre of Surgery named after Academician B.V. Petrovsky, Russian Academy of Medical Sciences,
Moscow, Russia

The work was based on the findings obtained by a comprehensive examination and surgical treatment of 217 patients with primary varicose veins of the lower limbs.

Depending on the method of operative intervention, the patients were subdivided into two groups. Group One consisted of 115 patients subjected to combined phlebectomy, while Group Two patients (n=102) underwent stem scleroobliteration (SSO).

Of the 217 patients, there were 48 (22.1%) men and 169 (77.9%) women. The patient groups matched by gender, age, severity and dissemination of the pathological process.

The long-term results surgical operations were followed up to five years.

By five years of follow-up in Group One (n=115), the convalescence group consisted of 47 (40.9%) patients, with the group of the "true" relapses comprising a total of 23 (20%) patients, and the group of "false" relapses consisting of 45 (39.1%) patients. By five years of follow-up in Group Two (n=102), the convalescent group comprised 44 (43.1%) patients with the group of the "true" relapses comprising 21 (20.6%) patients and that of the "false" relapses consisting of 37 (36.3%) patients.

We took the relapses to mean the return of the disease, i.e., development of varicosity of the saphenous veins on the postoperative extremity, with the "true" relapses being considered as those having developed resulting from an erroneously performed operation, namely: leaving the stump of the great saphenous vein with the affluents, unliquidated horizontal refluxes and recanalized trunks of the great saphenous vein or small saphenous vein following SSO. To the "false" relapses was referred further progressing of varicose disease.

Hence, 20.3% of all relapses were found to deve op resulting from an inaccurately performed operation, with 37.7% of all relapses having developed as a result of a varicosity in the previously intact basin of the saphenous veins. No statistically significant differences in the incidence rate of the relapses were revealed between the groups [59.1% in Group One patients and 56.9% in Group Two (P>0.05)].

KEY WORDS: varicose veins, phlebectomy, scleroobliteration.

P. 89

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