Signs and symptoms of saphenous nerve injury after greater saphenous vein stripping: prevalence, severity, and relevance for modern practice

Morrison, Charles; Dalsing, Michael C.

doi:10.1016/s0741-5214(03)00790-0

Cited by 124 publications

(74 citation statements)

References 7 publications

(10 reference statements)

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“…Morrison had declared similar results with transient nerve deficits. The symptoms consistent with nerve injury after complet GSV stripping affected quality of life in only 2.3% at long term evaluation 14 . According to a recently published study, complet GSV stripping showed better nerve injury results (19% at one month) than the nerve injury results of restricted GSV stripping of another study (27% after surgery) 8,17 .…”

Section: Discussionmentioning

confidence: 92%

“…Currently, the only way to decrease the need for further operation in varicose veins, is routine stripping 13 . GSV stripping in patients suffering from superficial venous insufficiency ensures clear improvements in the quality of life 8,9,14 . It also should not be forgotten that when the saphenous vein is already displaying varicoses and incompetency, it will be unstable to use it as a graft.…”

Section: Discussionmentioning

confidence: 99%

“…In thigh stripping, where the saphenous vein segment between the groin and the knee have been removed, lower nerve injury rates have been encountered 1,13 . Stripping that ends at the knee-level may decrease risk of paresthesia , but does not totally eliminate it 14,15 . In a study, upper segment stripping and stab avulsions have caused 36.5% loss of sensation and 8% paresthesia 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Lower rates of recurrence may be achieved in the application of complete stripping on patients who have whole saphenous insufficiency from the saphenofemoral junction to the ankle named " type I " by well ligating tributaries and the stump in the groin and applying careful dissection and appropriate stripping 11,14 . Nerve injury and related permanent complications do not occur at a severe level as to negatively affect the life of a patient.…”

Section: Discussionmentioning

confidence: 99%

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Should complete stripping operation to the ankle be avoided in the treatment of primary varicose veins due to greater saphenous vein insufficiency?

Uncu

2009

Acta Cir. Bras.

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Purpose:The most preferred method for the treatment of primary varicose veins due to greater saphenous vein (GSV) insufficiency is saphenofemoral high ligation and thigh stripping of the GSV, and ambulatory phlebectomy. Stripping is usually ended at the knee level to prevent nerve injury in the calf. However, different surgical modalities may be used depending on the surgeon's choice and experience. Methods: We present the results of complete stripping of the GSV to the ankle and ambulatory phlebectomies performed by a single surgeon. Ninety-six patients (102 limbs) who underwent standardized surgical procedure were participated in this study. Median follow-up time was 3.4 years. Results: All complaints due to varicose veins were resolved in all extremities. Some temporary complications observed were resolved fully during follow-up. Permanent paresthesia which was the most important complication was found only in two patients (2%). No recurrence was observed. Conclusion: The risk of saphenous nerve injury in the calf should not to be considered a reason to avoid complete stripping of the GSV to the ankle. If it is applied carefully and with appropriate technique, complete stripping still seems to be a good treatment option. Key words: Varicose Veins. Phlebotomy. Saphenous Vein. Venous Insufficiency. RESUMOObjetivo: O método de escolha para o tratamento das varizes primárias devido a insuficiência da veia safena magna (VSM) é a ligagura safenofemoral e a fleboextração em coxa e a flebectomia ambulatorial. A fleboextração é geralmente feita ao nível do joelho para prevenir a lesão neurológica no tornozelo. Diferentes modalidades operatórias, no entanto, podem ser utilizadas dependendo da escolha e da experiência do cirurgião. Métodos: Apresentamos os resultados da fleboextração completa da VSM até o tornozelo e flebectomias ambulatoriais realizadas por um único cirurgião. Noventa e seis pacientes (102 membros) que foram submetidos a procedimento cirúrgico padrão participaram deste estudo. A mediana do tempo de seguimento foi 3,4 anos. Resultados: Todas as queixas devido a varizes foram resolvidas em todos os pacientes. Algumas complicações temporárias observadas foram resolvidas totalmente durante o tempo de seguimento. Parestesia permanente que foi a complicação mais grave ocorreu apenas em dois pacientes (2%). Não observamos recurrência. Conclusão: O risco da lesão do nervo safeno no tornozelo não deve ser considerada uma razão para evitar-se a fleboextração completa da VSM até o tornozelo. Se é aplicada cuidadosamente e com a técnica apropriada, fleboextração ainda parece ser uma boa opção de tratamento.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Should complete stripping operation to the ankle be avoided in the treatment of primary varicose veins due to greater saphenous vein insufficiency?

Uncu

2009

Acta Cir. Bras.

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“…Bu hastaların postoperatif 3.ayda 2 (%40) tanesinde safen sinir hasarı ile ilgili şikayetlerin düzeldiği görüldü. Safen ven striping işleminin kasıktan ayağa doğru yapılmasıyla safen sinir hasarının azaldığını gösteren çalışmalar mevcuttur (3,9). Kliniğimizde striping işlemi kasığa doğru uygulanmaktadır.…”

Section: Tartışma Bulgularunclassified

Early Results of Varicose Vein Surgery

Cakir¹,

Tuncel²,

Uncu³

et al. 2012

J Turgut Ozal Med Cent

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ÖzetAmaç: Biz bu çalışmamızda kliniğimizde alt ekstremite varis cerrahisi yaptığımız hastaların erken dönem sonuçlarını sunmayı amaçladık. Gereç ve Yöntem: Kliniğimizde Nisan 2011-Eylül 2011 tarihinde alt ekstremite varis cerrahisi yaptığımız 36 hasta çalışmaya alındı. Tüm hastalara preoperatif bilateral alt ekstremite venöz doppler USG çekildi. Bulgular: Hastaların yaş ortalaması 39,6 (18-60) yıl idi. Hastaların 23'ü erkek 13'ü kadın idi. Tüm hastalar spinal anestezi altında operasyona alındı. 17 hastaya sağ alt ekstremite striping ve flebektomi, 1 hastaya sağ alt ekstremite flebektomi, 14 hastaya sol alt ekstremite striping ve flebektomi ve 4 hastaya da sol alt ekstremite flebektomi yapıldı. 18 hasta, klinik görünüm, etiyolojik faktör, anatomik dağılım ve patofizyolojik durum sınıflamasına göre (CEAP) evre 3, 16 hasta evre 4-5 ve 2 hasta evre 6 idi. Doppler USG'de 31 hasta da safen vende reflü saptandı. Bu hastaların tümüne striping işlemi uygulandı. Sonuçlar: Kliniğimizde CEAP evre 1-2 hastalarına endovenöz lazer ablasyon yöntemini, evre 3 ve üzeri hastalarda ise cerrahi tedaviyi tercih ediyoruz. Doppler USG'de safen vende reflü saptanan hastalarda, sadece yüksek ligasyon değil beraberinde striping işlemini uyguluyoruz. Anahtar Kelimeler: Variköz Ven; Cerrahi; Tedavi.+This article presented at 6.th National Flebology Congress on 13-15 January 2012, Istanbul. Early Results of Varicose Vein SurgeryAbstract Aim: We aimed for early results of patients that had undergone lower extremity varicose vein surgery in our clinic. Material and Method: Thirty-six patients were included in the study that had lower extremity varicose vein surgery between April 2011 and September 2011 in our clinic. Bilateral lower extremity venous duplex ultrasonography (USG) was performed to all patients, preoperatively. Results: Mean age of patients was 39.6 (18-60). Twenty-three of patients were male and 13 were female. Spinal anesthesia was used for all patients in operation. Right lower extremity stripping and ambulatory phlebectomy was performed for 17 patients, left lower extremity stripping and ambulatory phlebectomy for 14 patients, left lower extremity phlebectomy for 4 patients and a right lower extremity phlebectomy for one patient. Eighteen patients were CEAP (Clinical severity, Etiology or cause, Anatomy, Pathophysiology) Classification Class 3, 16 patients were CEAP Class 4-5 and 2 patients were CEAP Class 6. Great saphenous vein reflux was detected for 31 patients on the Doppler USG and stripping procedure was performed on all these patients. Conclusions: We prefer endovenous laser ablation method for patients if CEAP classification is class 1-2 but we prefer surgical treatment for patients if CEAP classification is class 3 and above in our clinic. We applied not only high ligation but also stripping procedure for the surgical treatment of patient with saphenous vein reflux which was detected with Doppler ultrasonography.

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Management of Varicose Veins and Venous Insufficiency

Hamdan

2012

JAMA

116

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Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

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Signs and symptoms of saphenous nerve injury after greater saphenous vein stripping: prevalence, severity, and relevance for modern practice

Cited by 124 publications

References 7 publications

Should complete stripping operation to the ankle be avoided in the treatment of primary varicose veins due to greater saphenous vein insufficiency?

Should complete stripping operation to the ankle be avoided in the treatment of primary varicose veins due to greater saphenous vein insufficiency?

Early Results of Varicose Vein Surgery

Management of Varicose Veins and Venous Insufficiency

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