Incidence of saphenous nerve injury after total stripping of greater saphenous vein: Its severity and effect on life

Abstract

Introduction: Total stripping of great saphenous vein is common practice since it reduces the need for reoperation. However, the incidence of saphenous nerve damage is higher in total stripping than in the conventional stripping. Methods: Fifty-seven patients who underwent total stripping of great saphenous vein were studied to find out the incidence of saphenous nerve damage, its severity and effect on day-to-day activities. Data was collected using an interviewer administered questionnaire and a detailed neurological examination of the leg. The questionnaire included questions on symptoms of saphenous nerve damage, its severity and its impact on their day-to-day life and Aberdeen Venous Severity Score (AVSS) to assess outcome of surgery for varicosities. Results: The age of patients ranged from 17 to 79 years with mean age of 44.7 (SD 15.80) years. Men comprised 56.1% of the sample. Fifteen out of 57 legs (26.3%) had evidence of saphenous nerve damage either by symptoms or by sensory deficit or by both. Patients with saphenous nerve damage were not significantly different in terms of age, gender, pre-operative Clinical Aetiological Anatomical and Pathophysiology (CEAP) class, post-operative CEAP class, post-operative AVSS, follow up interval or presence of recurrent varicosities when compared with those who didn’t have saphenous nerve damage. Among those who had evidence of saphenous nerve damage, only one had persistent symptoms with minimal discomfort in day-to-day activities. Thirteen (22.4%) patients had recurrent varicosities generally presenting as isolated clusters and none of them necessitated to have reoperation with median follow up of 12 months. The acceptance of the operation among patients seems to be encouraging. Conclusions: According to the findings of this study, total stripping of great saphenous vein can be safely undertaken by general surgeons with acceptable risk of saphenous nerve damage. Most of saphenous nerve damages are subclinical and transient and have negligible effect on day-to-day activities.