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Comparing Foam Sclerotherapy Combined with Saphenofemoral / Saphenopopliteal Junction Ligation with Surgery Alone for Varicose Veins

Raiees Ahmad Malla, Senior Resident, Department of Surgery, S.M.H.S Hospital and Govt Medical College, Srinagar- 190010, J&K, India. , Aftab Akbar1 , Raiees Ahmad Malla2 , Naseer Ahmad Awan3 , Javid Ahmad Peer4 , Mumtaaz – U Deen Wani5 , Arjumand Khurseed6

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New Indian Journal of Surgery 9(3):p 366-371, May-June 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9318.23

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Abstract

Background: Among chronic venous insufficiency, varicose veins are the most common manifestation affecting upto 25% of women and 15% of men [1]. While conventional surgical treatment for varicose veins has proven effective, it has fallen out of favour due to time away from work, poor cosmesis and procedural complications.

Materials and Methods: The present study was conducted in the Postgraduate Department of General Surgery, Government Medical College Srinagar from February 2013 to October 2014 in 100 patients randomly divided into two groups A and B, each group having 50 patients irrespective of age and sex. Patients in group A underwent Sapheno femoral Junction Ligation and Greater Saphenous Stripping/ Multiple Ligations or Saphenopopliteal Junction Ligation and Lesser Saphenous Stripping/Multiple Ligations. Patients entitled for study in Group B underwent Foam Sclerotherapy Combined with Saphenofemoral Junction / Saphenopopliteal Junction Ligation.

Results: Most of our patients in our study belonged to working age group of 20- 49 years, showing female predominance of varicose veins in our study: In group A in 48 (96%) patients the procedure was successful whereas in group B 44 (88%) had successful outcome. In group A operative time ranged from 70 to 100 min with mean of 83.72 min , S.D of 9.15 and S.E of 1.83 whereas in group B the operative time ranged from 40 to 60 min with mean of 50.96min, S.D of 6.37 and S.E of 1.27. In group A time required to return to work ranged from 4-16 days with mean time of 9.4 days and in group B it ranged from 1-8 days with mean time of 3.92 days (p<0.001). In group A 1 (2%) patient developed recurrence after procedure where as in group B 3 (6%). No major complications like pulmonary embolism, anaphylaxis, stroke occurred in our study except one case of DVT in foam group. Minor complications reported included skin pigmentation, superficial thrombophelibits, wound infections.

Conclusion: Ultrasound guided sclerotherapy combined with sapheno-femoral ligation was found to be safe, very effective, less expensive, involved a shorter treatment time and resulted in more rapid recovery compared to sapheno-femoral ligation, and was cosmetically cosmetically better, with shorter duration of hospital stay compared to surgery alone. It has high patient satisfaction results and improvement in quality of life.

Keywords: Foam Sclerotherapy; SPJ /SFJ Ligation; Varicose Veins.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9318.23

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