IS RECURRENCE OF VARICOSE-VEINS AFTER SURGERY UNAVOIDABLE

Recurrence of varicose veins is a common problem. Four main reasons fo r recurrence are discussed: insufficient understanding of venous anato my and haemodynamics, inadequate preoperative assessment, incorrect or insufficient surgery and development of new locations of superficial- to-deep insufficiency. Better insight in the variable anatomy of the v enous system and better training of junior surgeons in this matter may improve the results of venous operations. Accurate preoperative asses sment using (colour) duplex sonography should permit the surgeon to gi ve the patient a differentiated, individualized treatment. Careful dis section of the saphenofemoral junction combined with additional stripp ing of the long saphenous trunk to just below the knee appears to be t he best way to prevent recurrence from the long saphenous vein in the thigh. Concerning the short saphenous vein preoperative location of th e exact level of the saphenopopliteal junction is of major importance in the prevention of recurrence. In this way, all diagnostic and surgi cal efforts should aim to minimize recurrence to about only 5% of pati ents.