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Optimising a varicose vein service to reduce recurrence
E P Turton1, S McKenzie, M J Weston
1Department of Vascular and Endovascular Surgery, St James's and Seacroft Teaching Hospital Trust, Leeds.
Annals of the Royal College of Surgeons of England
|January 10, 1998
Summary
Surgical trainees can perform varicose vein surgery adequately under supervision. Postoperative duplex scans revealed new reflux sites in some patients, potentially due to altered venous hemodynamics.
Area of Science:
- Vascular Surgery
- Medical Education
- Diagnostic Imaging
Background:
- Varicose vein surgery is a common procedure.
- Ensuring surgical trainee competence is crucial for patient outcomes.
- Recurrence due to inadequate surgery is a concern.
Purpose of the Study:
- To evaluate the adequacy of primary varicose vein surgery performed by surgical trainees.
- To assess the role of duplex scanning in identifying reflux.
- To investigate the development of new reflux sites post-surgery.
Main Methods:
- Prospective observational study of 63 legs in 49 patients.
- Surgery performed by surgical trainees under consultant supervision.
- Pre- and postoperative duplex scanning to identify venous reflux.
Main Results:
- Preoperative duplex identified saphenofemoral junction (SFJ) or long saphenous vein (LSV) incompetence in 59 limbs.
- Surgery abolished all preoperative reflux sites.
- Postoperative scans revealed 17 new reflux sites in 12 limbs within 6 months.
Conclusions:
- Surgical trainees can adequately perform varicose vein surgery with consultant supervision and accurate preoperative assessment.
- New reflux sites may develop post-surgery due to altered venous hemodynamics.
- This approach supports training and reduces recurrence from inadequate surgery.