[Lymphatic complications from variceal surgery].

Abstract

Introduction: Lymphatic injuries are unavoidable during varicose vein surgery. However these injuries seldom lead to complications. This study was held to try to find an explanation to this contradiction which seems to be only noticeable.

Material and method: If anatomy shows that it is impossible to operate on varicose veins without injuring lymphatic vessels, the regeneration power of these latters, known for a long time, is such that complications due to these injuries are all the more exceptional that surgeries are less traumatizing than it used to be. Nowadays, each surgeon is only faced to a small number of such complications during their career. This rareness makes a methodical personal study quasi-impossible. That is why we sent a questionnaire to about thirty surgeons specialized in this field. This questionnaire, about their experience, dealt with lymphatic complications they had met during varicose veins surgery.

Results: Twenty three answers were sent in time and deal with more than 184,000 surgeries. The lymphatic complication rate is about 8.7%, 5.4% of which are lymphorrhea, 2.6% of lymphocele, 1.09% of lymphangitis and 0.5% of lymphoedema. Of course, these figures are approximate. Lymphoedema is the only long-lasting lymphatic complication of the varicose veins surgery.

Conclusions: According to us, sclerotherapy seems to be more effective than surgery, in case of signs, even benign, of lymphatic insufficiency.