International Journal of Pharma and Bio Sciences
 
 
    ISSN 0975-6299
www.ijpbs.net


ORIGINAL RESEARCH ARTICLE
Int J Pharm Bio Sci Volume 14 Issue 3, July-September 2023, Pages:17-24

Outcomes of Surgical Management of Varicose Veins with and Without Venous Stripping: A Comparative Study

Dr. Katti Ravi Kumar, Dr Kari Veerabhadra Swamy, Dr. Mude Sarala and Dr Megavath Motilal
DOI: http://dx.doi.org/10.22376/ijpbs.2023.14.3.b17-24
Abstract:

Varicose veins are tortuous, widened veins in the subcutaneous tissues of the legs and are often visible. Invasive management methods include sclerotherapy, Trendelenburg operation, GSV stripping, perforator ligation, sub-fascial endoscopic perforator surgery (SEPS), and stab avulsion. The present study aimed to compare outcomes of surgical management of varicose veins with and without venous stripping at Siddhartha Medical College, Vijayawada, Andhra Pradesh, India. The study's objectives include comparing early ambulation of the patient, healing of wounds, postoperative hospital stay, postoperative pain relief, and recurrence between the two groups. It is an interventional, randomized, single-blinded study. 100 patients admitted with varicose veins at the tertiary care center Siddhartha Medical College, Vijayawada, Andhra Pradesh, from March 2021 to September 2022, were taken as the study sample. 100 patients were randomized in groups I and II, each containing 50. Group I included patients who underwent saphenofemoral flush ligation(SFL) by stripping the great saphenous vein up to the knee. Group II included patients who underwent SFL and subfascial ligation of the incompetent perforators in the thigh and leg. Patients were followed up for six months. Results showed no significant difference in the mean age of patients in both groups. 72% of patients were males. Early ambulation was significantly good among patients without venous stripping (Group II). The two groups have no significant difference in wound healing and duration of postoperative hospital stay, pain relief, and recurrence rate. 8% of patients had recurrence during the follow-up period in group I. Sapheno femoral junction (SFJ) flush ligation with incompetent perforators ligation without venous stripping is better than SFJ flush ligation with incompetent perforators ligation with venous stripping.

Keywords: Comparative study, Outcome, Surgical management, Varicose veins, Venous stripping.
Full HTML:
  1. Campbell B. Varicose veins and their management. BMJ. 2006;333(7562):287-92. doi: 10.1136/bmj.333.7562.287, PMID 16888305.
  2. Van den Boezem PB, Klem TM, le Cocq d’Armandville E, Wittens CH. The management of superficial venous incompetence. BMJ. 2011;343:d4489. doi: 10.1136/bmj.d4489, PMID 21816743, Google Scholar.
  3. Ren S, Liu P, Zou N, Tan X. Better outcomes of varicose veins with EVLT alone than in combination with Trivex by GRA. J Grey Syst. 2008;20(3):195-204. Google Scholar.
  4. Liu P, Ren S, Yang Y, Liu J, Ye Z, Lin F. Intravenous catheter-guided laser ablation: a novel alternative for branch varicose veins. Int Surg. 2011;96(4):331-6. doi: 10.9738/cc44.1, PMID 22808616.
  5. Liem TK, Moneta GL, Brunicardi FC. Schwartz?s principles   of   surgery. 9th ed. McGraw-Hill Education; 2019. p. 777-89.
  6. Zollinger RM, Ellison EC. Zollinger?s Atlas of Surgical Operations. 9th ed. McGraw-Hill Education; 2016. p. 360-1.
  7. Tisi PV. Varicose veins. BMJ Clin Evid. 2011 Jan 5;2011:0212. PMID 21477400, PMCID PMC3217733.
  8. Balasubramaniam V. A comparative study on the outcome of surgical management of varicose veins with and without venous stripping. Int Surg J. 2017;8(3):822-5. doi: 10.18203/2349-2902.isj20210517.
  9. Bhunia A, Mandal K, Das MK. The post-operative outcome of varicose veins surgery with special reference to saphenofemoral ligation without stripping of the great saphenous vein. Int J Sci Res. 2020;9(2):2271.
  10. Biemans AA, Kockaert M, Akkersdijk GP, van den Bos RR, de Maeseneer MG, Cuypers P, et al. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg. 2013;58(3):727-34.e1. doi: 10.1016/j.jvs.2012.12.074, PMID 23769603, Google Scholar.
  11. Tellings SS, Ceulen RP, Sommer A. Surgery and endovenous techniques for the treatment of small saphenous varicose veins: a review of the literature. Phlebology. 2011;26(5):179-84. doi: 10.1258/phleb.2010.009095, PMID 21357623, Google Scholar.
  12. Bush RG, Hammond K. Treatment of incompetent vein of Giacomini (thigh extension branch). Ann Vasc Surg. 2007;21(2):245-8. doi: 10.1016/j.avsg.2006.07.008, PMID 17349373, Google Scholar.
  13. Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg. 2011;98(8):1079-87. doi: 10.1002/bjs.7555, PMID 21725957, Google Scholar.
  14. Ren S, Liu P. Initial clinical experiences in treating 27 cases of varicose veins with EVLT plus TRIVEX. J US-China Med Sci. 2005;2(1):4-8. Google Scholar.
  15. Lin F, Zhang S, Sun Y, Ren S, Liu P. The management of varicose veins. Int Surg. 2015 Jan;100(1):185-9. doi: 10.9738/INTSURG-D-14-00084.1, PMID 25594661, PMCID PMC4301287.
  16. Evans CJ, Fowkes FG, Ruckley CV, Lee AJ. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidemiol Community Health. 1999;53(3):149-53. (PMC Free article). doi: 10.1136/jech.53.3.149, PMID 10396491, Google Scholar.
  17. Mishra S, Ali I, Singh G. A study of epidemiological factors and clinical profile of primary varicose veins. Med J DY Patil Univ [serial online]. 2016;9(5):617-21. doi: 10.4103/0975-2870.192169.
  18. Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):e088. doi: 10.5435/JAAOSGlobal-D-17-00088, PMID 30211382, PMCID PMC6132313.
  19. Morales Cuenca G, Moreno Egea A, Aguayo Albasini JL. Compression therapy after varicose vein surgery. Can the classic elastic bandage be improved upon? Cir Esp. 2011;89(9):629-30; author reply 630. doi: 10.1016/j.ciresp.2010.12.023, PMID 21723547, Google Scholar.
  20. Kendler M, Wetzig T, Simon JC. Foam sclerotherapy-a possible option in therapy of varicose veins. J Dtsch Dermatol Ges. 2007;5(8):648-54. doi: 10.1111/j.1610-0387.2007.06310.x, PMID 17659037, Google Scholar.
  21. VASHISHT M, SEN J. Management of saphenofemoral junction (SFJ) incompetence in varicose veins: simple high ligation or stripping – A prospective randomized study. Internet J Surg. 2011;27(1).
  22. Bhunia A, Mandal K, Das M, Jana D. Post-operative outcome of varicose vein surgery with special reference to saphenofemoral ligation without stripping of the great saphenous vein. Int J Sci Res. 2020: 9(2);8179:2277.
  23. Weddell JM. Varicose veins pilot survey, 1966. Br J Prev Soc Med. 1969 Aug;23(3):179-86. doi: 10.1136/jech.23.3.179, PMID 5798460.
  24. Brand FN, Dannenberg AL, Abbott RD, Kannel WB. The epidemiology of varicose veins: the Framingham Study. Am J Prev Med. 1988 Apr;4(2):96-101. doi: 10.1016/S0749-3797(18)31203-0, PMID 3395496.
  25. Prashanth A, Nandagopalan K. A clinical epidemiological study of varicose veins. IOSR JDMS. 2019;18(6):80-91.
  26. Prasad NLE, Balra N. Comparison of ligation versus ligation with the stripping of the long saphenous vein in varicose veins of the lower limb. Asian Pac J Health Sci. 2016 Mar 30;3(1):117-20. doi: 10.21276/apjhs.2016.3.1.17.
  27. Ms. DJRN. Clinical study and management of varicose veins. J Med Sci Clin Res. 2017;05(1):15473-80. doi: 10.18535/jmscr/v5i1.46.
  28. Reddy GVR, Abhilash V, Harshavardhan Y, Ravikiran B. Management and outcome of lower limb varicose veins: a hospital-based follow-up study. Int Surg J. 2019;6(7):2538. doi: 10.18203/2349-2902.isj20192988.
  29. PATEL P, MEHTA K. A study of different modalities in the treatment of lower limb varicose veins. MedPulse International Journal of Surgery. 2018;5(1):26-9.
  30. Kam MH, Tan SG. Results of long saphenous vein stripping. Singapore Med J. 2003 Dec;44(12):639-42. PMID 14770259.
  31. Natraj DT, Hussain DAZ, Rajachidambaram DK. A retrospective comparison on surgical management of varicose veins with and without venous stripping. Int J Surg Sci. 2020;4(2):614-9. doi: 10.33545/surgery.2020.v4.i2g.453.
  32. H N, Hebbar A, Rajaput A, Bv S. Prospective clinical study of surgical management of varicose veins of lower limb and its complications. Int J Res Med Sci. 2014;2(1):306. doi: 10.5455/2320-6012.ijrms20140258.
  33. Liu P, Peng JL, Zhang F, Wang ZB, Zhang M, Niu XP, et al. Comparison of modified above-knee and conventional surgery with the stripping of the great saphenous vein of varicose veins of the lower extremities: A retrospective study. Comput Math Methods Med. 2022;2022:7730960. doi: 10.1155/2022/7730960://www. PMID 35069794.
[Download PDF]
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy
Pharmaceutical Fields
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmaceutics
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Novel drug delivery system
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Nanotechnology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacognosy
© Copyright 2009-2015 IJPBS, India. All rights reserved. Specialized online journals by ubijournal. Website by Ubitech Solutions
         Home I Contact I Terms & Conditions