[Economic aspects of varices surgery. A plea for ambulatory treatment]

Health expenses have increased in recent years in the majority of western countries. The treatment of varicose veins of the lower limbs occupies an important position from the budgetary point of view, and the duration of hospitalisation is clearly a determining factor. Apart from other methods currently being investigated--Dextran, intermittent pneumatic compression, anti-aggregants--low dose heparin therapy appears to be 80% effective in the prevention of post-operative thromboembolic complications. In the same way local complications after varicose surgery--haematomas, lymphoedema--have disappeared, as a result of progress in surgical technique (fine, atraumatic dissection, rigorous haemostasis) and improvement in methods of bandaging. In the light of our last fifty ligations and stripping of the internal saphenous vein, notably without thromboembolic complications, it seems reasonable to consider short hospital stays, of three days, with the exception of "high risk" patients. "Out-patient" treatment (24 hours) can be considered for patients who are "active and motivated".