[Venectomy under local tumescent anaesthesia]

The authors have analysed the findings of the examination and outcomes of surgical management of 142 patients with lower limb varicosity (a total of 160 lower extremities). Of theses, there were 52 (36.6%) men, and 90 (63.4%) women. The patients' age varied from 18 to 74 years old (mean age 44+/-11.1 years). The average duration of the disease amounted to 8.3+/-5.2 years. The distribution according to the CEAP clinical classes was as follows: C2 - 90 patients (63.4 %), C3 - 43 (30.3 %), C4 - 6 (4.2 %), C5 - 3 (2.1 %). The proportion of the patients with large varicose veins (more than 1 cm in diameter) amounted to 31.25%. Lesions of the bed of the great saphenous vein (GSV) were observed on 139 lower limbs (86.8%), of the small saphenous vein (SSV) - on 19 lower limbs (11.9%), and of both the GSV and SSV - on two lower extremities (1.3%). In all the cases, the operation was performed under local tumescent anaesthesia in outpatient conditions. The anaesthetic mixture was based on 0.2 - 0.5% ropivacain. The subjective score of the anaesthesia quality averaged 9.6 points. Immediate postoperative complications were observed in 1.4% of the patients (lymphorrhoea and wound process). Side effects of anaesthesia in the form of a vegetovascular reaction, transient cutaneous paresthesia, and a skin reaction were noted in 8.4% of the patients. Local postoperative haematomas were observed in 9.1% of cases. A total of 83.8% of the patients did not use tabletted analgetics in the postoperative period. The subjective assessment of the surgical intervention performed and postoperative outcomes achieved was excellent to good in 98.6% of the patients.