Optimized Surgical Strategies for Acute Thrombophlebitis of Varicose Veins in the Lower Extremities

Purpose: This study aimed to evaluate and compare the efficacy of two-stage and single-stage surgical strategies in the management of acute thrombophlebitis of varicose veins in the lower extremities, focusing on postoperative complications, recovery time, and overall patient outcomes. Materials & Methods: A retrospective analysis was conducted on 102 patients diagnosed with acute thrombophlebitis of varicose veins between 2020 and 2024 at the Izhevsk Republic Clinical Hospital. Patients were classified according to F. Verrel’s classification (1998) into four groups based on the extent of thrombosis. Conservative therapy, single-stage radical phlebectomy, and two-stage surgical treatment (crossectomy followed by radical phlebectomy) were used based on the type of thrombosis and patient condition. Results: Of the patients, 17 received conservative therapy, 48 underwent two-stage surgery, and 37 underwent single-stage surgery. The two-stage approach significantly reduced complications such as wound infections (6.3% vs. 13.9%) and nerve damage (5.1% vs. 16.2%) compared to the single-stage approach. Additionally, patients undergoing the two-stage procedure showed improved quality of life and faster recovery times. Conclusion: The two-stage surgical strategy offers superior clinical outcomes over single-stage interventions, significantly reducing postoperative complications and enhancing recovery. It is recommended as the optimal treatment approach for acute thrombophlebitis of varicose veins, particularly in more severe cases.