The phlebological surgery in elderly patients

The pathogenesis of the lower limbs varicose veins in the elderly patients is the same one as in the juvenile and adult age. What changes is the severity of the clinical picture, because the disease is a chronic pathology and it is aggravated with the passing of the years in absence of prophylaxis and missed or inadequate therapy. Equally the surgical operations on the superficial venous system of the elderly patients from a technical point of view are the same that are practiced in other ages of life. What changes is the anaesthesiological risk, which is increased, because other chronic pathologies are frequently associated with the old ones. Currently both the use of techniques of peripheral anesthesia, as the blocks of the lower limbs nervous trunks, and the introduction of poor toxic anesthetics for the heart in therapeutical practice allow in an inci¬sive way to submit elderly people to surgical procedures. Above all the out-patient hemodynamic surgery of the superficial chronic venous insufficiency, which requires a careful and meticulous instrumental investigation aimed surgical gestures, but simple, effective, of brief duration, has convinced many surgeons of the possibility to operate on the varicose patients of a more and more advance age. On the other hand the rapid postoperative mobiliza¬tion of those sick, in absence of immediate complica¬tions, means that they can be discharged from the hospital on the same day of the operation. This undoubtedly involves positive reflexes on the sanitary expense and it increases at the same time the compliance in terms of motivation and acceptance of the proposed procedure. The elderly patient, perhaps more than the younger adult, once informed of the new anaesthesiological and surgical techniques, gladly gives his consent to the inter¬vention, pleased to return to his own house and tquickly return to his daily occupations. How much I dictate you is translated in our experi¬ence, that is carried out near the Phlebological Center of the Siena University, in a progressive increase in the last 5 years both in absolute terms (223) and percen¬tages (12%) of the number of subjects older than sixty¬five years old that have been submitted to surgical operations for the venous disease. Of all 223 patients, males are 68 and females are 155; 144of them have an age between 66 and 70 years, 73 belonging to the eighty years of life and 6 subject to the ninty. All patients have been operated in Day Hospi¬tal admission. No mortality has been found. Local post-operative complications was encountered in 1,8% of the cases.