[Repeated surgery in recurrences following operation for essential varices]

Among 2,129 patients operated on between 1964 and 1976, we found 109 postoperative recurrences requiring a repeated operation. The causes of recurrence are various, but in the majority of cases, it results from an operative mistake. Most commonly (69 cases) there is a defective removal of the arch of the internal saphenous vein. Next, in order of frequency, is a recurrence along the course of the internal saphenous vein (28 cases) which has either not been stripped at all or only partially stripped (recurrence on the sural internal saphenous). "Neglected" external saphenous was found 29 times. Sometimes it had been insufficiently resected (6 cases). Finally, one of the commonest causes of recurrence is due to an eccentric perforating vein which has been neglected in the course of the stripping (35 cases). Very often these different lesions are combined. Repeated surgery must be radical and carefully performed and the patient should be followed up regularly by a phlebologist.