[Elimination of major trunk reflux as a basis for surgical management of lower limb varicosity]

Abstract

The article reviews the available literature data related to the problem of eliminating the blood reflux along the trunks of saphenous veins in lower limb varicosity. The authors have herein classified the literature-proposed interventions depending on the underlying principle, to have also carried out a detailed analysis of the data contained in the available Russian and foreign publications, as well as having considered technical peculiarities concerning different methods of removing veins, i. e., phlebectomy according to the Babcock technique, inversion venectomy, and cryophlebectomy. The article also deals with comparing therapeutic outcomes and a wide variety of postoperative complications involved. The role of the trunk catheter sclerosing therapy in comprehensive management of varicose disease is also discussed herein. Special attention is paid to the present-day techniques aimed at removing the trunk reflux, i. e., with the help of radio-frequency and laser-mediated obliteration. The currently available information about both advantages and disadvantages of these methods necessitates further studies aimed at searching for an optimal method (or a combination of methods) of removing one of the most important links of pathogenesis of varicosity.