Study of different surgical management approach in lower limb varicose veins at tertiary care hospital

Mohd Shafiuddin; T. P. Bhavanishankar

doi:10.18203/2349-2902.isj20173184

Authors

Mohd Shafiuddin Associate Professor, Department of Surgery, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, India
T. P. Bhavanishankar Professor, Department of Surgery, KIMS, Hubli, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20173184

Keywords:

Complications, Long saphenous, Trendelenburg’s operation veins, Varicose veins

Abstract

Background: The present study was conducted with the aim to evaluate the clinical features and management of varicose veins in terms of recurrence and symptoms improvement.

Methods: This clinical study was conducted for a period of two years during January 1990 to February 1992. A total of 21 patients who presented with symptoms of varicose veins in lower extremities to Karnataka Medical College Hospital Hubli were involved in the study. After thorough clinical examination and investigation all the patients are subjected to relevant treatment.

Results: Long saphenous system is the most common venous system affected by varicosity in 18 (85.7%) cases. Incompetence of perforator veins was seen in about 20 (95.3%) cases. Trendelenburg’s operation was done in all cases of long saphenous involvement. Sub fascial ligation of perforators was done in 2 patients. Wound infection is the common postoperative complication observed in 5 patients. Preoperative stay in hospital was longer in patients with ulcer (13 days), whereas patients with postoperative wound infection (14 days) had longer postoperative stay.

Conclusions: This study showed that the prevalence of lower limb varicose veins has a male predominance and is more common in younger age group. Occupation involving standing for longer periods of time is one of the important contributing factors in the development of varicosities. There is no single method of appropriate treatment for all cases. Multiple ligations of saphenous vein and excision of varicosed tributaries were done in 9 patients. If cases are selected properly with good operative technique the complications are negligible.

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References

Subramonia S, Lees TA. The Treatment of Varicose Veins. Ann R Coll Surg Engl. 2007;89(2):96-100.

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.

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.

Stephen C. Nicholls. Sequelae of Untreated Venous Insufficiency. Semin Intervent Radiol. 2005;22(3):162-8.

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.

Van den Boezem PB, Klem TM, le Cocq d'Armandville E, Wittens CH. The management of superficial venous incompetence. BMJ. 2011;343:d4489.

Lin F, Zhang S, Sun Y, Ren S, Liu P. The Management of Varicose Veins. Int Surg. 2015;100(1):185-9.

Bailey H. Demonstration of physical sign in clinical surgery, Ed. Clain A 16 edition; 1973:30-32.

Janugade HB, Patil BP, Tata NH, Saygaonkar HV, Janugade DH, Dokania V. Clinical profile and management of lower limb varicose veins. 2017;6(2):1615-22.

Vaidyanathan S, Balkrishnan V. Role of Ambulatory venous pressure studies in venous disorders of the lower limb. Indian J Surg. 1986:48.

Nagaraj H, Hebbar AK, Rajaput AS, Kumar BVS. Prospective clinical study of surgical management of varicose veins of lower limb and its complications. Int J Res Med Sci. 2014;2:306-9.

Callum MJ. Epidemiology of Varicose veins. British J Surg. 1994;81:167-3.

Mirji P, Emmi S, Joshi C. Study of Clinical Features and Management of Varicose Veins of Lower Limb. J Clin Diagn Res. 2011;5(7):1416-20.

Pavan Prasad BK, Prem Kumar A. Clinical Study of varicose veins and their management. Int J Biomed Advance Res. 2015;6(08):564-8.

Cambell WB. Varicose vein, an increasing burden for the NHS. British Med J. 1990;300:763-4.

Ravinder Naik J, Noonavath RN. Clinical Study and Management of Varicose Veins. JMSCR. 2017;5(1):15473-80.

Donnell TFO, Burnand KG, Clemenson G, Thomas ML, Browse NL. Doppler examination vs clinical and phlebographic detection of the location of incompetent perforating veins. Arch Surg. 1977;112:31-2.