[Surgery of recurrent varices of the minor saphenous vein].

BACKGROUND

Investigation of the diagnostic and technical problems of redo surgery of the lesser saphenous vein for primary varicose veins.

DESIGN

a retrospective study.

SETTING

Section of Vascular Surgery in a University Hospital.

PATIENTS: Fifteen lower extremities were operated upon (13 patients, 3 males and 10 females, ages ranging from 43 to 65 years with a mean of 53.2).

INTERVENTIONS: Each case was assessed by clinical examination, duplex scanning and venography (ascending venography and/or varicography). Surgical procedure was carried out via a longitudinal approach over the popliteal region or the posterior aspect of the thigh. Each case presented with a stump of the lesser saphenous vein.

MEASURES: Hemodynamic (correction of reflux of the lesser saphenous vein) and clinical (improvement of clinical state in the operated lower limb and complications) results were evaluated.

RESULTS

Reflux at the ostium of the lesser saphenous vein was corrected in 15/15 (100%) cases. Clinical result was good in 15/15 (100%) cases. Postoperative edema was observed in 7/15 (46.7%) cases. Lesion of the common peroneal nerve with paresis of the foot dorsal flexion was found in 1/15 (6.7%) cases. Hypertrophic scar was observed in 4/15 (26.7%) cases.

CONCLUSIONS

Redo surgery of the lesser saphenous vein is requested less frequently than other surgical procedures for superficial venous diseases. This surgery requires two essential features: a) accurate diagnosis of the lesser saphenous vein insufficiency; b) adequate surgical technique. For the former purpose, venography is a fundamental method of assessment. Surgical technique should be cautious and gentle. A longitudinal approach leads to a wide exposure of the structures in the popliteal fossa.