[The analyze of recurrent varicose veins development after surgical treatment of lower limbs varicose veins].

Possible development of recurrent varicose veins (RVV) is one of the main reasons for abandonment of patients to undergo varicose veins surgical treatment. Regardless of the increase in the number of the treatment the primary method of improving the surgical technique is to identify the causes of earlier failures. The aim of this study was to determine the mechanisms responsible for the development of recurrent varicose veins after surgical treatment of primary varicose veins. We studied 507 patients (680 limbs) with primary varicose veins of the lower limbs operated in the years 1996-2007 using the classical technique. The results of pre-and postoperative signs, duplex studies and operational protocols were analyzed. Follow-up was 36-156 months (mean 89.7 +/- 31.2 months). RVV development was observed in 36.9% of operated limbs. Irregularities of surgical techniques and neovascularization were responsible for the development of changes to 87.6% and disease progression in the development of changes in 27.4% of limbs with RVV. At 15.5% of limbs with RVV occurred more than one cause of relapse. In logistic regression combined effects of several factors shown to exist only significant relationship between development and the presence of RVV stumps in sapheno-femoral junction (SFJ) and the presence of inefficient SFJ tributaries of the stumps. The risk of development of new varicose veins was independent on the correctness of the implementation of the first treatment. The most common cause of development of RW were imperfections of surgical treatment, principally in the form of leaving the stumps with insufficient SFJ tributaries, or the development of neovascularization. It appears that improving the quality of treatment may favorably affect the development of a decreased incidence of recurrent varicose veins.