AMBULATORY PHLEBECTOMY

BACKGROUND. Ambulatory phlebectomy (AP) is a gratifying technique that allows one to solve problems otherwise requiring traditional surgery. However, when AP is practiced indiscriminately, results may be disapp ointing and can tarnish the technique, although there is always a solu tion to restore the situation. OBJECTIVE. To evaluate the defects of A P, their frequency, and to propose solutions for treatment and prevent ion. METHODS. This study was based on a review of 900 patients who und erwent AP with no less than 6 months follow-up. Complications were gro uped into three categories: cosmetic, functional, and efficacious (rec urrence rates). RESULTS. Cosmetic problems included pigmentation, tatt ooing, telengiectatic matting, and appearance of new varicose veins. F unctional problems included paresthesia and edema. Hematomas disappear ed within 3 weeks but sometimes led to pigmentation. CONCLUSIONS. Afte r having analyzed all the reasons for complications, we call formulate logical solutions. Risks may be greatly reduced by strict adherence t o proper technique, patient selection, and pretreatment venous mapping . For all complications we found a solution. Sclerotherapy is used in all cases because AP, like all surgical techniques, leads to recurrenc e when performed alone. In this study, all the described side effects were treated by sclerotherapy, which remains the only solution that gi ves good results in all cases.