THE ROLE OF OPERATIVE MANAGEMENT OF VARICOSE VEINS IN PATIENTS WITH LYMPHEDEMA AND/OR LIPEDEMA OF THE LEGS

Abstract

The role of operative management of “symptomatic” varicose veins in patients with lowerextremity lymphedema or lipedema is controversial. We reviewed the clinical outcome of 261patients between 1989-1997 at the Földiclinic with lower extremity lymphedema (68 patients),lipo-lymphedema or lympho-lipedema (103 patients) or lipedema (90 patients) who hadundergone operation for varicose veins. In each group, the results were dismal as leg swellingworsened or was unchanged in greater than 90% whereas symptoms such as heaviness, fatigue,cramps (termed varicogenic symptomatology) were improved in less than 10%. These findingssupport that operations for varicose veins in the legs of patients with lymphedema, lipedema, orcombinations of these disorders should be undertaken only if there is an absolute indicationpresent (ascending phlebitis and/or bleeding). Otherwise, complete decongestive physiotherapyis still the best treatment approach for these groups of patients.