Invited commentary

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This report from one of China’s leading centers for venous disease is of special importance because it is indicative of the high level of venous practice currently used in China, where chronic venous disease is considered to be an important problem. The patients in this series have been well studied and carefully observed after surgery (three times in the first year) with clinical and ultrasound scans.

The Chinese apparently harbor a high percentage of primary reflux cases. The aggressive management of reflux espoused in this article differs from the usual practice in the West and may be useful in stimulating healthy debate. Regardless of the differences in management between East and West, the disease processes are clearly the same, and the diagnostic workups are similar. The CEAP classification is used to good advantage in this study to identify the patient population being treated, and this will make it possible to compare results from this source with different theories of management in other parts of the world. As the differences are defined, investigations to study and resolve the newly recognized problems will emerge.

Participation of the Chinese in the discourse concerning management of chronic venous disease provides many advantages that will increase the opportunity for progress in the field. With the realization that we are now using the same instruments to measure the same aspects in patients who have the same diseases, it is possible to reap some of the benefits that were predicted to flow from progress in noninvasive diagnosis and from uniformity of classification.