| Abstrakt: |
Objective: To compare clinical disability, ambulatory venous pressure (AVP) and leg volume before and after venous surgery, and to relate the changes to those observed after one night preoperative in-hospital rest.Design: Prospective study.Setting: Department of Vascular Surgery, University Hospital, Paris, France.Subjects: Nineteen patients with primary varicose veins and mild chronic venous insufficiency (CVI), scheduled for venous surgery.Main outcome measures: Clinical disability recorded by the analogue scale method, and leg volume and AVP measurements. These evaluations were repeated three times: on the day before surgery, in the afternoon; in the early morning on the day of surgery; and 2 months after surgery, in the afternoon.Results: Varicose vein surgery improved disability (p= 0.001) and two AVP parameters: recovery time (RT, p= 0.0049) and the calf muscle pump index (CMPI), which rose by 345% (95% confidence intervals: 29, 659). Preoperative supine rest for one night improved disability (p= 0.0016) and reduced leg volume (p= 0.0002). The improvements induced by surgery correlated with the changes induced by rest, for disability (p= 0.016), RT (p= 0.006) and CMPI (p= 0.033).Conclusion: Surgery improves venous function in patients with primary varicose veins. AVP remains a standard method of evaluating CVI. Combined with volumetry, it allows sensitive comparisons between different treatments. Because venous function varies greatly with daily activity, it is imperative to standardize the times at which venous function is evaluated. |
