[Surgery of the saphenous-popliteal junction: a delicate procedures with potential risks]

The authors evaluate the results achieved in two groups of patients operated on for varicose veins in small saphenous vein (SSV) territory in 3 year interval. In the first group gathered from January to December 1998 (114 patients--36 men and 78 women, 123 procedures--118 primary and 5 re-do) the operative indication was based on the clinical examination and continual doppler evaluation. These patients were operated on in general, spinal or local and flash general anaesthesia. In the second group gathered in the same period of the year 2001 (72 patients--21 men and 51 women) 75 procedures were performed (3 patients with bilateral operation). In this group, 49 patients with 50 procedures were selected. The diagnosis was based not only on clinical and continuous doppler examination, but mainly on colour flow duplex mapping. The operation was performed on strictly ambulatory basis using pure local anaesthesia completed with small dose of sedation. Any patient needed complementary sclerotherapy one month after procedure. In mid-term follow-up complementary conservative treatment was necessary in 51 p.c. of the whole series.

Use of colour coded duplex ultrasound in preoperative evaluation of varicose veins patients enabled us to precise preoperative diagnosis, to diminish the number of aggressive surgical procedures in favour of less traumatic operations and to perform this surgery on ambulatory basis. Nevertheless, small sahenous vein surgery still remains delicate and sometimes also hazardous.