1Assistant Professor, Department of General Surgery, Hamdard Institute of Medical Sciences and Research (HIMSR), New Delhi
2Assistant Professor, Department of General Surgery, Hamdard Institute of Medical Sciences and Research (HIMSR), New Delhi
Online published on 24 July, 2018.
Varicose veins legs are one of the most common but often neglected vascular disorders at our place. Endothermal ablation is now the preferred therapy nowadays1. This problem being so common and non-availability of endovascular intervention at most centers, we intended to study its usual presentation and the outcome of conventional surgical management.
The study was conducted at department of surgery, Patna Medical College, Patna. CEAP (clinical-etiology-anatomy-pathophysiology) classification was used to classify the chronic venous disorders and a total of 50 consecutive patients, 18 years or older in age having CEAP grade e ”2 varicose veins undergoing surgical management was included in this study. Baseline characteristics, clinical examination and Color duplex scanning findings were noted. Patients having varicosities >3mm with competent SFJ and were managed with injection sclerotherapy. Those with varicosities >3mm and/or incompetent SFJ were managed with Trendelenburg's operation along with stripping of LSV. Patients with perforators were managed with Trendelenburg's operation along with stripping of LSV and subfascial ligation of perforators. Post procedural complications and recurrence up to 6 months of follow up was noted.
Of the total 50 patients 76% were male and the mean age was 33.78 ± 13.66, maximum numbers of the patients were in 20–40 yrs. age group (66%). Regarding risk factors 30% of the patients were having occupation requiring long hours of standing. 12 (24%) of the patient had some sort of advanced complication (C3+) at presentation. 40%, 38% and 22% of the patients underwent Injection sclerotherapy, stripping and stripping + subfascial ligation respectively. Injection sclerotherapy was associated with no significant post procedural complication but 1 case had recurrence. 15.8% of Trendelenburg's operation + LSV stripping and 18.2% of Trendelenburg's operation + LSV stripping with subfascial ligation had some post procedural complications, but they had no recurrence at 6 months.
Significant proportion of patients present with advanced complication of varicose veins. Conventional surgical management in varicose veins is associated with acceptable post procedural complication and relatively good short term outcome.
