[Indications for and results of ambulatory varices therapy]

The introduction of the stab-incision--phlebectomy (Muller's technique)--has opened a large field for ambulatory surgery. This is specially true when phlebectomy is combined with a saphena-femoral or saphena-popliteal ligature. In a series of 1825 operations including 1592 incompetent saphenous veins 1216 (67%) were performed under local anesthesia. Radical surgery of incompetent short saphenous veins as well as of minor forms of varicose long saphenous veins is feasible in local anesthesia. Regional or general anesthesia (609 operations) are still recommended for stripping procedures in advanced long saphenous varices. In most cases phlebectomy of varices (553) provides a better cosmetic result than sclerotherapy, the latter being the treatment of choice for small veins and telangiectasias. Ambulatory surgery and sclerotherapy are cost-effective and low-risk treatments. No deep vent thrombosis or pulmonary embolism was observed in this group, whereas 1 DVT and 2 PE occurred in the 609 operations performed under general anesthesia.