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Subject Area

General Surgery

Article Type

Original Study

Abstract

Background Varicose vein surgery is characterized by high recurrence rate of 60% after 5 years of follow-up observation, and this is a disappointing finding, both for the patients and the surgeon. Objective The aim was to study cases of recurrent varicose veins after surgery regarding incidence, causes, and management. Participants and methods This descriptive prospective cohort study was carried out on all patients who underwent surgery for primary varicose veins from June 2017 to June 2020 in our vascular outpatient's clinics. All patients were assessed by a preoperative clinical examination and color duplex imaging to establish the incidence, causes, and management of the recurrent cases. Results During the study period, 120 operative procedures were performed for primary varicose veins. Only 45 patients enrolled in our study showed recurrence. The incidence of recurrence was 37.5%. Regarding the cause of recurrence detected by duplex ultrasound, 33 patients (73.3%) had disease progression, four patients (8.9%) had inadequate surgery, five patients (11.1%) had incompetent perforator, one patient (2.2%) had inadequate surgery and incompetent perforator, and two patients (4.4%) had neovascularization. Regarding the management of recurrence, 28 patients (62.2%) were subjected to conservative treatment, seven patients (15.7%) were subjected to two sessions of injection sclerotherapy with 4 weeks between the sessions, and surgery was needed in 10 patients (22.2%). Conclusion Recurrent varicose veins after surgery are inevitable part of treating venous disease. The common causes of recurrence are disease progression, inadequate surgery, neovascularization, and incompetent perforators.

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