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Room for improvement in reoperation for varicosities of the small saphenous vein.

INTRODUCTION
This study was conducted to evaluate the qualitative and quantitative effects of surgery for recurrent varicosities of the small saphenous vein (SSV). To our knowledge, English-language original articles on this subject have not previously been published.


MATERIAL AND METHODS
We identified 47 patients who had had surgery for recurrent varicosities of the SSV between November 2005 and June 2008 at the Vascular Department, Gentofte Hospital, Copenhagen. Twenty-eight were women and 19 were men. Three had had bilateral surgery, so a total of 50 legs had been operated. All patients had their re-surgery to the SSV performed by experienced vascular surgeons after duplex scanning.


RESULTS
The subjects' median age was 57 years at surgery (range 31-67 years) and the median follow-up period was 15 months after secondary surgery (range 3-31 months). Postoperative duplex scan showed 25 legs with no reflux, 19 legs with neovascularisation at the saphenopopliteal junction (SPJ) and six legs with surgical failure. Examination for nervous lesions showed two legs with severe change in sensibility compatible with damage to the sural nerve. Eight legs had small asymptomatic areas of sensibility change. Among the studied patients, 39 out of 50 reported a positive effect on symptoms after re-surgery.


CONCLUSION
Only 25 of the operations resulted in no reflux of the SPJ. But 39 out of 50 patients reported an overall positive effect on symptoms after re-surgery. Re-operation of the SSV should only be performed by dedicated vascular surgeons and endovenous methods should be explored.