Abordagens cirúrgicas no tratamento de varizes

Abstract

Chronic venous disease of the lower limbs is a very common medical condition globally, with the reflux of the great saphenous vein being the most frequent form of insufficiency. It causes an individual burden, by leading to deterioration of quality of life of the patient, and a social burden on the budgets of health systems. Traditionally, high ligation of the saphenofemoral junction associated with stripping of the great saphenous vein was considered the goldstandard technique in the treatment of varicosities. However, in the last few years, the minimal invasive methods have been accepted as safe and efficient alternatives to the classic approach.Several comparative articles were searched in “Journal of Vascular Surgery”, “European Journal of Vascular and Endovascular Surgery”, “Phlebology: The Journal of Venous Disease”, “Cochrane” and “PubMed”.Review of the techniques was based on a total of 12 articles (prospective studies, randomized and nonrandomized clinical trials, coorte studies) with follow‐up periods ranging from 16 weeks to 5 years.In a short and medium term, the new techniques present with several advantages over stripping: less pain, shorter period of convalescence, better quality of life scores and greater patient satisfaction. However, it was not possible to assert a superiority of these methods over the traditional approach in a long term. More studies are needed, with longer follow‐up periods, particularly randomized controlled trials.