Results of Long Saphenous Vein Stripping

MH Kam, SG Tan
Correspondence: Mr Tan Seck Guan, gsutsg@sgh.com.sg

ABSTRACT
Objective To audit retrospectively all long saphenous vein stripping performed or supervised intra-operatively by a single surgeon over a seven-year period.
Patients One hundred and twenty-four patients (156 limbs) operated primarily in standard surgeon-supervised operations, were audited.
Methods All patients were questioned via telephone interviews, and those with symptoms or recurrent varicosities were recalled for clinical review and investigations by the surgeon.
Results Eighty-seven cases presented with lower limb pain, 36 with eczema and 27 with ulcer. Eighty-one percent of operations were performed for symptomatic varicose veins and 19% were done for cosmesis. There were 153 limbs with varicosities, 121 of these had documented long saphenous vein reflux preoperatively. One hundred and sixteen limbs resolved post-operatively, five did not resolve, and four recurred. Incompetent perforators and short saphenous veins were the commonest causes of non-resolution and recurrence. Complications, including five cases of saphenous nerve paraesthesias, were temporary and met with full resolution eventually.
Conclusion A 96% success rate is possible after high tie, stripping of the long saphenous vein with multiple avulsions of varicosities. Recurrence is 3% over the period of follow-up.

Keywords: varicose veins, varicosities, long saphenous vein, short saphenous vein, venous reflux, vein stripping
Singapore Med J 2003; 44(12): 639-642