Feasibility of day case varicose vein surgery in a district general hospital

Mofidi, R.; Bello, A. O.; Mofidi, A.; Khan, Zahid Ali; Aly, Sherif; Joyce, William

doi:10.1007/bf03170482

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…The latter increases treatment cost but is supported by the Royal College of Surgeons Guidelines (1992) which suggest that procedures likely to take O1 h generally require in-patient surgery. 73 Furthermore, up to 42% of patients may need overnight stay following planned day case surgery for bilateral varicose veins 74 and 88% of such patients prefer a single operation with overnight stay rather than staged surgery. 75 A recent prospective study comparing recovery between unilateral and bilateral surgery found no difference in post-operative pain, analgesia use, postoperative stay, return to work and physical activity 67 although factors such as the type of employment or anaesthesia also influence when patients return to work.…”

Section: Recoverymentioning

confidence: 99%

Treatment Options for Primary Varicose Veins—A Review

Beale

Gough

2005

European Journal of Vascular and Endovascular Surgery

100

102

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Section: Recoverymentioning

confidence: 99%

Treatment Options for Primary Varicose Veins—A Review

Beale

Gough

2005

European Journal of Vascular and Endovascular Surgery

100

102

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“…Some of the western studies followed the basis of day care in varicose vein surgery and found that it is safe, feasible and more cost effective. 6,7 In our series, no cases gave definite history of deep vein thrombosis and also no case had superficial thrombophlebitis. This finding was in conformity with some authors that the superficial thrombophlebitis as a cause of varicose veins is very rare and most probably phlebitic changes occur in the veins which are already varicosed.…”

Section: (2%)mentioning

confidence: 54%

Prospective clinical study of surgical management of varicose veins of lower limb and its complications

et al. 2014

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Background: Varicose veins of the lower extremities are the most common peripheral vascular disease and their treatment is as old as mankind. This prospective clinical study of surgical management of varicose vein was conducted to study the age, sex and occupational distribution of varicose veins of lower limb. Evaluations of clinical features and surgical methods of treatments that were in practice in the management of varicose veins in terms of recurrence and symptoms improvement were also studied. Methods: Two years prospective study was conducted in our institution from May 2007 to April 2009. During this period 62 cases of varicose veins of lower limbs were admitted to our hospital of which 50 cases were selected and were studies in detail. After thorough clinical examination and relevant investigation they are all subjected to surgical management. Results: Out of 50 cases studied, 21 (42%) had only long saphenous vein involvement, 7 (14%) had short saphenous vein involvement and in 5 (10%) cases both short and long saphenous system were involved. In addition to long saphenous vein involvement, incompetent perforators were present in 17 (34%) cases. Among them prominent veins and pain were the main complain in 38 (78%) patients. Itching and pigmentation were present in 4 (8%) patients. Ankle edema was present in 6 (12%) patients. Pain and ulceration of lower leg were present in 2 (4%) patients. After clinical assessment appropriate surgical procedures were followed for each of patients. These cases were followed for 3 year durations. Out of 50 patients 7 (14%) patients had recurrence of varicose vein. 7 (14%) patient complained of recurrence of pain after 2 years of surgery but no appearance of varicose vein. One patient (2%) complained of persistence of pigmentation after surgery. 2 (4%) patients complained of persistence of ankle edema and there was complete healing of ulcer which was present earlier. Conclusions: Commonest age group of varicose vein of lower limb was 20 to 40 years. Definite relationship exists between the occupation and the incidence of varicose veins. The patients were in the occupation which required standing for long time had the higher chances of varicose vein. Severity of the symptoms is not proportional to the duration of varicose veins. The involvement of long saphenous vein is more common than the short saphenous vein. Since our study shows very low percentage of recurrence and symptoms related to varicose vein the surgical line of treatment is an ideal treatment for varicose vein. For incompetent perforators, sub-fascial ligation appears to be a better method of treatment than extra fascial ligation. Because in the former all the perforators could be visualized and dealt with, while in the latter there were chances of missing one or two perforators. If cases are selected properly with good operative technique the complications are negligible.

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“…Eine zeitlich nicht limitierte PubMed-Recherche mit den Suchbegriffen "varicose surgery inpatient" ergab 58 Treffer, von denen sich 11 zumindest teilweise auf die offene Varizenchirurgie beziehen [1][2][3][4][5][6][7][8][9][10][11]. Die PubMed-Recherche mit den Suchbegriffen "varicose surgery outpatient" ergab 303 Arbeiten.…”

Section: Ergebnisseunclassified

“…Noch bis in die 1990er-Jahre hinein war es ganz selbstverständlich, dass die offene Varizenchirurgie nicht ambulant, sondern stationär durchgeführt wurde. In den 1980er-Jahren wurden dann zunehmend Fallserien publiziert, welche die Möglichkeit widerspiegelten, die offene Varizenchirurgie auch ambulant durchzuführen [1][2][3][4][5][6][7][8]. Die initial jüngeren Patienten vorbehaltene ambulante Chirurgie wurde dann auch Anfang dieses Jahrtausends auf ältere Patienten ausgeweitet [9].…”

Section: Introductionunclassified

Offene Varizenchirurgie – wann ambulant, wann stationär?

Frings¹,

Rass²,

Bruning³

et al. 2020

Phlebologie

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Zusammenfassung Hintergrund Die offene Varizenchirurgie kann sowohl in einem ambulanten als auch in einem stationären Setting durchgeführt werden. Aktuelle Leitlinien zur Therapie der Varikose nehmen zu der Frage, welche Patienten ambulant und welche stationäre zu operieren sind, nicht Stellung. Fragestellung Erarbeitung von Kriterienkatalogen zur Frage einer ambulanten oder stationären Varizenoperation. Material und Methode PubMed-Recherche zur Fragestellung und basierend auf den Literaturdaten Erarbeitung eines Delphi-Konsensus der Autoren. Ergebnisse Zur Frage, ob eine Varizenchirurgie ambulant oder stationär durchgeführt werden kann, existieren lediglich 2 monozentrische retrospektive Analysen sowie eine Registerstudie. In diesen Studien werden ambulante Operationen im Wesentlichen bei Patienten mit Normalgewicht und ASA-Stadium 1 durchgeführt. Gut geeignete Lokalbefunde für eine ambulante Operation sind Primäreingriffe und ein geringeres C-Stadium der CEAP-Klassifikation. Für eine stationäre Varizenoperation sprechen ausgedehnte Befunde, bei denen mehr als eine Crosse saniert werden muss, Rezidiveingriffe in der Leiste oder der Kniekehle, vorangegangene thromboembolische Ereignisse, eine erhöhte Blutungsneigung aufgrund monströser Varizen oder einer Antikoagulation, Hautkomplikationen wie ein Ulcus cruris oder eine schwere Stauungsdermatitis bzw. Dermatosklerose sowie ein BMI über 30 bei Crossektomie. Schlussfolgerungen Basierend auf Literaturdaten und Expertenmeinungen konnten Kriterienkataloge für eine ambulante versus stationäre offene Varizenchirurgie erarbeitet werden.

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Feasibility of day case varicose vein surgery in a district general hospital

Abstract: Although varicose vein surgery is safe, acceptable and cost-effective as a day case procedure, if attempted in all-comers, overnight admission will be required in a significant proportion. Pre-operative selection is advised.

Cited by 11 publications

References 13 publications

Treatment Options for Primary Varicose Veins—A Review

Treatment Options for Primary Varicose Veins—A Review

Prospective clinical study of surgical management of varicose veins of lower limb and its complications

Offene Varizenchirurgie – wann ambulant, wann stationär?

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