Recurrent varices after surgery
The aim - analysis of causes and treatment of recurrent varices after surgery. Results of the study. At receipt of chronic venous insufficiency (CVI) of C2 was noted in 22 (38.5 %%) C3 26 (45.6%), and C4 in 9 (15.7%) cases. The vast majority of patients (n = 45 (78.9%)) were operated under general surgery departments of district general surgeons. Neoangi-ogenesis groin noted in 7 (12.2%) cases. In 8 (14%) cases in patients with primary operations were removed only varicose tributaries of the great saphenous vein trunk. Of the 57 patients, 6 (10.5%) had not revealed the presence of a remote trunk great saphenous vein in the thigh, and 4 (7%) cases marked by recanalization of the great saphenous vein trunk at the hip after EVLT. In 3 (5.3%) cases were identified long stump of the small saphenous vein. In 6 (10.5%) cases not removed at the trunk BPV tibia. In 3 (5.3%) cases were identified long stump of the small saphenous vein. In the remaining 23 cases noted the presence of varicose veins changed hypodermic pools large and small saphenous veins (GSV, SSV) (they are recorded in 9 cases residual varicose veins). Of the 57 patients, surgical treatment performed in 54 observations, surgical tactics depended on the location and cause of relapse. In 10 cases, resection of the stump of GSV/SSV and ligation of its tributaries. Just 10 patients made stripping the GSV trunk at the hip. In 14 patients we performed EVLT of trunk of the great saphenous vein and miniphlebectomy of tributaries. Conclusions. RVD in most cases is caused by tactical and technical errors after the initial operation, as well as the progression of the varicose veins and requires a differentiated approach in the treatment based on the study of venous hemodynamics using duplex scanning.