Perioperative sclerotherapy A survey of current practice by Italian phlebologically-active physicians

Abstract

IM: To find out how and when Italian phlebologically-active physicians apply perioperative sclerotherapy.

MATERIAL AND METHODS: A questionnaire was e-mailed to the members of three different Italian Societies of Phlebology. The answers were collected in a database (SPSS19 for Windows) and statistically evaluated.

RESULTS: Ninety surgeons (87.4%) and 13 (12.6%) phlebologists responded, 57 (56,3%) worked in hospital and 46 (44.7%) in an outpatient clinic. Perioperative sclerotherapy is administred by 63,1% of respondents merely postoperatively. 28,2% use also postoperative sclerotherapy, but sometimes in combination with preoperative (6.8%) or intraoperative sclerotherapy (21.4%). Only 8,7% perform the perioperative sclerotherapy pre-, intra- and/or postoperatively. Postoperative sclerotherapy is programmed in a significantly higher percentage and earlier in private practice. Vascular surgeons performed intraoperative sclerotherapy in a significantly higher percentage in comparison to non-vascular surgeons .

DISCUSSION: In contrast to the results of British and Irish surveys, Italian phlebologically-active physicians perform a remarkably higher percentage of perioperative sclerotherapy. Postoperative sclerotherapy is administered after 2,3±1,9 months. Private practitioners sclerose significantly earlier and more often compared to the in hospital operators. Postoperative sclerotherapy can be considered an adjuvant therapy in order to improve the surgical result and may be called “adjuvant sclerotherapy” in order to distinguish it from “sclerosurgery” or “ sclerostripping”, which are performed intraoperatively.

CONCLUSIONS: The answers of 103 partecipants give an acceptable overview on the current behavior of phlebologicallyactive physicians in private and public practice, in Italy. Perioperative sclerotherapy seems widely used, mainly as postoperative sclerotherapy, but also as sclerosurgery and more seldom as adjuvant sclerotherapy, and may lead varicose vein surgery to more miniinvasiveness. The rationale of “sclerosurgery” is manifold.