[Recurrent varices of the lower extremities and their causes]

Surgery of both primary and secondary varicose veins represents a serious medical and social problem. Middle-age patients are primarily affected. Hence, a great attention to this problem is appropriate and the surgery should be performed with great responsibility. On principle, we are opposed to sclerotization of veins as a primary medical treatment. During the surgery of varicose veins, a great attention should be paid to perfect crossectomy with ligation of all branches and leaving a short stump of vein saphena magna. The most important phase of the surgery, however, is the finding incompetent perforating veins (IP) and their correct treatment, since these are, as follows from our work, the most frequent cause of relapses. Incorrectly treated or left-out IP veins play a key role in the ethology of relapses. These IP veins are very often much broader then the original surface varicose veins. Pre-treatment examination is extremely important. It is necessary to know the condition of deep vein system and to find or identify IP veins. In no circumstances should the relapse veins (RV) surgery be limited to the deletion of varicose veins only. Reexamination of groin should be a rule. The rule of treating the cause and not the consequence should be valid in the case of RV surgery more then anywhere else.