A Prospective Study on Clinical Presentation and Surgical Management of Varicose Veins at a Tertiary Care Hospital in Bangalore, India

Abstract

Introduction: Varicose vein are abnormally dilated veins of lower limbs with defective valves. Incidence involves one out of five in the world and the problem is ever growing due to increasing population, increased life span and change in life style. Hence, there is a need to delineate the epidemiology of the varicose veins in the local population which visited the hospital. Aim: To study the various clinical presentations, management and complications of varicose veins. Materials and Methods: It was a prospective observational study; conducted by the Department of General surgery at Sri Siddhartha Institute of Medical Sciences and Research Centre, from September 2018-February 2020. All 75 patients enrolled were evaluated by detailed history, clinical examination and investigations- venous doppler study of the lower limbs, to locate the site of incompetence. All the cases that underwent surgical procedure were followed postoperatively for any complications every one month for development of surgical site infections, after three months for healing of ulcer and at six months for any signs of recurrence. The collected data was entered in Microsoft Excel spread sheet and analysed using descriptive statistics. Results: The study included 75 cases with primary varicose vein. The age of these patients ranged from 21-69 years. Male to female ratio was 1.5:1. Most of them were farmers (48%) by occupation requiring prolonged hours of standing. All cases presented with dilated veins. The common associated symptoms were pain (50.7%) followed by itching (28%) with slight increased incidence in the left lower limb (50.7%). Majority of the patients have involvement of long sephenous system (81.3%). Majority of them (48%) had combined valvular incompetence. Sapheno-femoral flush ligation with stripping appeared to be the best method of surgical management for incompetence in the long saphenous vein territory. Ten (13.3%) cases had postoperative complications. Conclusion: Varicose veins are a common disease, middle age group, males and occupation with prolonged hours of standing are affected the most. Surgical procedures have beneficial effects in minimising morbidity due to varicose vein.

Keywords

• doppler ultrasound
• long saphenous vein
• lower limb
• trendelenburg operation
• ulceration
• valvular incompetence