Surgical management of varicose veins and its complications

Abstract

Background: Varicose veins affects at least 1 out of 5 in world. Varicose veins and their associated symptoms and complications constitute chronic vascular disorders requiring surgical treatment. In developing countries like India, studies encompassing the clinical evaluation and management of varicose veins on the conventional lines seems a necessity to improve the quality of care with the available resources. Objectives: To study the clinical presentations, surgical management and its outcome and complications associated with varicose veins in lower limbs. Methods: A total of 30 patients with primary varicose veins were sourced from cases admitted to Kamineni Institute of Medical Sciences from October 2019 to August 2021. They were investigated, operated and followed up, and the final outcome evaluated. All the information was taken down in the proforma designed for the study. Results: In the study, it was noted that the varicose veins affect the young adult and middle age population (20-50yrs). Most of the patients were males (60%) and majority of patients sought medical help for one or the other complications (92%). Long saphenous vein involvement was seen in 93.3% of patients and both LSV & SSV involvement in 20%. A great number of patients had perforator incompetence (80%). Duplex Ultrasound of the venous system proved to be a crucial and clinching investigation. Sapheno-femoral flush ligation with stripping was the most commonly performed surgery (46.7%), with addition of Subfascial ligation in a few cases. Most patients had uneventful recovery, with a few cases suffering complications such as hematoma, seroma and wound infection. These resolved in follow-up, however, saphenous neuritis was a persistent complication in 3 patients. Conclusion: Majority of the patients with varicose veins were associated with complications and surgical management with stripping of path of incompetence (i.e. LSV trunk) with incompetent perforator ligation appear to be best option for lower limb varicose veins under our settings.