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[Experience with surgical treatment of ascendant varicophlebitis]
Insights
Radical surgical treatment for ascendant varicophlebitis, including great saphenous vein removal and varicose vein excision, leads to better recovery. This comprehensive approach, combined with early mobilization and heparin prophylaxis, showed fewer residual complaints and favorable economic outcomes.
Area of Science:
- Vascular Surgery
- Phlebology
Context:
- Ascendant varicophlebitis presents complex treatment challenges.
- Current management strategies require evaluation for efficacy and patient outcomes.
Purpose:
- To evaluate the effectiveness of a radical surgical approach for ascendant varicophlebitis.
- To compare outcomes between radical treatment and other surgical techniques.
Summary:
- The study proposes radical removal of the great saphenous vein and all varicose veins in one session for ascendant varicophlebitis.
- Diagnostic tools like ultrasonic doppler flowmeter and duplex scan are recommended to assess thrombosis extension, with phlebography reserved for suspected deep venous involvement.
- Surgical techniques, including thrombectomy with Fogarty catheter for deep venous affection, are discussed. Postoperative care emphasizes early mobilization and low-dose heparin prophylaxis, deeming antibiotics generally unnecessary.
- Thirty-seven interventions were performed without significant complications, and a one-year follow-up revealed fewer residual complaints in the radically treated group.
Impact:
- Radical surgical treatment demonstrates improved recovery rates and reduced long-term complaints in patients with ascendant varicophlebitis.
- The active surgical approach offers favorable economic consequences due to quicker and more definitive patient recovery.
- This study supports a comprehensive surgical strategy for managing varicophlebitis, potentially setting a new standard of care.
Abstract:
In ascendant varicophlebitis, the authors suggest not only crossectomy, but also radical removal of the dilated part of the great saphenous vein and of all thrombosed and non-thrombosed varicose veins in one session. They consider it important to clear the extension of the thrombosis by using an ultrasonic doppler flowmeter or the duplex scan technique; phlebography is needed only if deep venous affection is suspected. Cardinal questions of the operative technique are discussed. In cases of deep venous affection, thrombectomy is performed with Fogarty catheter. Antibiotics are generally held to be unnecessary, but early mobilisation and postoperative low-dose heparin prophylaxis are of great importance. No significant complications were detected after 37 interventions. Every patient was controlled one year after surgery. Residual complaints were found more rarely in the radically treated group. As concerns the quick and definitive recovery, mention is made of favourable economic consequences of the active surgical treatment.