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

Abstract

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.