PURPOSE: To assess venous hemodynamics and quality of life at lest five years after varicose vein stripping. METHODS: We conducted a prospective study with 39 patients (63 limbs) with primary lower limbs varicose veins. Preoperatively, all patients were subjected to clinical evaluation, duplex ultrassound, air plethysmography (APG), and CIVIQ questionnaire of quality of life. By APG, venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) were determined. CIVIQ addresses four domains in course of 20 questions, including states of physical, social, and psychological well-being, and pain level. Varicose veins were treated by standard venous stripping. At least five years after surgery (77.9 ± 10.9 months), patients were reassessed and had clinical examination, duplex ultrasound, APG, and CIVIQ repeated. No late follow-up data was available for 24 patients. RESULTS: Preoperative and late postoperative VFI levels were similar, whereas EF (P=0.05) and RVF (P=0.01), as hemodynamic variables, significantly improved following surgery. In the late postoperative period, overall CIVIQ scores were significantly lower (P=0.005), as were scores in all four domains: pain (P=0.001), physical (P=0.007), social (P=0.008), and psychological (P= 0.05). CONCLUSION: In a small prospective cohort, improvements in venous hemodynamics and in quality of life of patients submitted to standard varicose veins stripping were maintained five years after the procedure.

The present study aimed to experimentally evaluate the protection role of glycerin preserved bovine peritoneum (BP) against intestinal adhesions to a vascular graft. Experiments were performed on 24 adult rabbits, randomly dived into two groups. All animals were submitted to a vascular graft over the infra-renal aorta and vena cava. Group 1(12 animals ) was submitted to a BP patch on the retroperitoneal opening, between the vascular prosthetic graft and the intestinal loops. Group II (12 animals ) had the retroperitoneal opening sutured. After 7, 14, 28 and 60 days, 3 animals of each group were randomly killed and the retro peritoneum, with or without the BPpatch, was removed for histological analysis. The histological analysis showed that the BP stimulated a moderate to intense inflammatory reaction at the beginning of the experiments and on the 60-day evaluation, the inflammatory reaction was mild, limited to the BP border with its histological structure preserved. In conclusión, the BP is a safe and cheap interposition material to be used between vascular grafts and intestinal loops, presenting a protection role against adhesions between them.

El objetivo de este estudio fue evaluar experimentalmente el rol protector del peritoneo bovino (PB) preservado en la glicerina en contra de las adherencias intestinales de un injerto vascular. Los experimentos se realizaron en 24 conejos adultos, randomizados aleatoriamente en dos grupos. Todos los animales fueron sometidos a un injerto vascular sobre la aorta infra-renal y la vena cava. Grupo I (12 animales), fue sometido a un parche PB en una apertura retroperitoneal suturada, entre el injerto vascular y el intestino. Grupo II (12 animales) con la apertura retroperitoneal suturada. Después de 7, 14, 28 y 60 dias, 3 animales de cada grupo fueron sacrificados al azar y el retro peritoneo, con o sin el parche de PB, se retiró para el análisis histológico. El análisis histológico mostró que la PB estimuló una moderada a intensa reacción inflamatoria al inicio de los experimentos y en la evaluación de 60 dias, la reacción inflamatoria fue leve, limitada a los bordes de la PB con su estructura histológica preservada. En conclusión, la PB es una forma segura y barata de material de interposición para ser utilizada entre injertos vasculares e intestinales, presentando un rol de protección contra adherencias entre ellos.