A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up
Based on a presentation given at the Forty-second Annual Meeting of the Vascular Surgical Society of Great Britain and Ireland, November, 2006, and published in abstract in Br J Surg 2007; 94: A256.
Received 26 December 2007; accepted 1 April 2008. published online 01 July 2008.
Objective
The aim was to examine the effect of various surgical maneuvers during standard surgery for small saphenous varicose veins (SSV).
Methods
This was a prospective cohort study of patients that underwent small saphenous varicose vein surgery. Two-hundred nineteen consecutive patients (234 legs) with isolated primary or recurrent small saphenous varicose veins undergoing surgery were enrolled in a multicenter study involving nine vascular centers in the United Kingdom. Operative technique was determined by individual surgeon preference; clinical and operative details, including the use of stripping, were recorded. Clinical examination (recurrence rates) and duplex imaging (superficial and deep incompetence) were evaluated at six weeks and one year after surgery.
Results
A total of 204 legs were reviewed at one year; 67 had small saphenous varicose vein stripping, 116 had saphenopopliteal junction (SPJ) disconnection only, and the remainder had miscellaneous procedures. The incidence of visible recurrent varicosities at one year was lower after SSV stripping (12 of 67, 18%) than after disconnection only (28 of 116, 24%), although this did not reach statistical significance. There was no significant difference in the rate of numbness at one year between those who had SSV stripping (20 of 71, 28%) and those who had disconnection only (38 of 134, 28%). The rate of SPJ incompetence detected by duplex at one year was significantly lower in patients who underwent SSV stripping (9 of 67, 13%) than in those who did not (37 of 115, 32%) (P < .01).
Conclusion
Stripping of the SSV significantly reduced the rate of SPJ incompetence after one year without increasing the rate of complications.
aDepartment of Vascular Surgery, Gloucestershire Royal Hospital, Gloucester, United Kingdom
bRoyal Devon and Exeter Hospital and Peninsula College of Medicine and Dentistry, Exeter, United Kingdom
Reprint requests: Jonothan J. Earnshaw, MD, Gloucestershire Royal Hospital, Western Road, Gloucester GL1 3NN, United Kingdom
The study was funded through contributions from the individual research departments.
ABSTRACT