A clinical study of varicose veins and their management in patients attending the surgical department of a tertiary hospital
Üçüncü basamak bir hastanenin cerrahi bölümüne başvuran hastalarda varisli damarlar ve yönetimi üzerine klinik bir çalışma
Keywords:Varicose veins, Venous doppler, Dilated veins, Venous ulcers.
Varicose veins are abnormally dilated, tortuous and elongated veins that occur in the lower limbs. The patients usually present to the surgical outpatient department with various clinical presentations such as, dilated veins, venous ulcers over the legs, pigmentation of the skin and lipodermatosclerosis to name a few. Venous doppler is a very important investigation that must be done in a cases of varicose veins.The surgical treatment involves sapheno-femoral junction flush ligation with stripping of the varicose vein. Several other modalities are also available today such as, sclerotherapy and endovascular laser ablation (EVLA).
The objective of this study was to determine the clinical profile of the patients who presented with varicose veins and to determine the treatment that was offered to them to treat the varicose veins. This study was carried out from September 2015 to August 2018. A total of 62 patients were studied. The statistics were analysed using SPSS package 20.0. Ethical clearance was obtained from the institutional ethics committee.
The presence of dilated veins was the most common complaint with which patients presented to the surgical outpatient department. The most common surgical procedure that was performed was the sapheno-femoral junction flush ligation with stripping of the varicose vein. This study shows the importance of diagnosing a case of varicose veins and to determine as early as possible the treatment modality that should be offered to the patient.
Varisli damarlar, alt ekstremitelerde meydana gelen anormal şekilde genişlemiş, kıvrımlı ve uzamış damarlardır. Hastalar genellikle genişlemiş damarlar, bacaklarda venöz ülserler, deride pigmentasyon ve lipodermatoskleroz gibi çeşitli klinik tablolarla cerrahi polikliniğine başvururlar. Venöz doppler, varisli damarlarda mutlaka yapılması gereken çok önemli bir tetkiktir. Cerrahi tedavi variköz venin soyulması ile safeno-femoral bileşke yıkama ligasyonunu içerir. Günümüzde skleroterapi ve endovasküler lazer ablasyon (EVLA) gibi başka yöntemler de mevcuttur.
Bu çalışmanın amacı varis ile başvuran hastaların klinik profilini belirlemek ve varis tedavisi için kendilerine sunulan tedaviyi belirlemekti. Toplam 62 hasta incelendi. İstatistikler SPSS paketi 20.0 kullanılarak analiz edildi. Kurumsal etik kuruldan etik izin alındı.
Genişlemiş damar varlığı hastaların cerrahi polikliniğine en sık başvurduğu şikayetti. Uygulanan en yaygın cerrahi prosedür, varisli damarın soyulması ile safeno-femoral bileşke yıkama ligasyonu idi. Bu çalışma, bir varis olgusunun teşhis edilmesinin ve hastaya sunulması gereken tedavi yönteminin mümkün olduğunca erken belirlenmesinin önemini göstermektedir.
Wills V, Moylan D, Chambers J. The use of routine duplex scanning in the assessment of varicose veins. Australian and New Zealand J Surg. 1998;68(1):41-44.
Kim J, Richards S, Kent PJ. Clinical examination of varicose veins- A validation study. Ann R Coll Surg Engl. 2000;82:171-175.
Irodi A, Keshava SN, Agarwal S, Sadhu D. Standardisation of preoperative marking of incompetent perforators and saphenopopliteal junction on Doppler with evaluation of “t” technique. Indian J Surg 2011;73:37-39.
Vashist M, Godara G, Rajesh R, Sen J, Panwar S. Management of varicose veins: Status of clinical examination and colour Doppler in the present Indian scenario. Internet J Surg. 2013;20:7613.
Delbe and Mocquet. Varicose veins and deep vein thrombosis: epidemiology and suggested aetiology. Br Med J. 2005;2:556.
Labropoulos N, Giannoukas AD, Delis K, Mansour MA, Kang SS, Nicolaides AN, et al. Where does venous reflux start?. J Vascular Surg. 1997;26(5):736-742.
Subbarao NT, Aradhya SS, Veerabhadrappa NH. Sclerotherapy in the management of varicose veins and its dermatological complications. Indian J Dermatol Venereol Leprol. 2013;79(3):383-388.
Vaidyanathan S. Deep vein obstruction: management strategies. In: Chronic venous disorders of the lower limbs. Springer; 2015, p:195-203.
Mirji P, Emmi S, Joshi C. Study of clinical features and management of varicose veins of lower limb. J Clin Diagn Res. 2011;5(7):1416-1420.
Pavan Prasad BK, Prem Kumar A. Clinical study of varicose veins and their management. Int J Biomed Advance Res. 2015;6(08):564-568.
Barros FS, Perez JM, Zandonade E, Salles-Cunha SX, Monedero JL, Hilel AB, et al. Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography. J Vascular Brasileiro. 2010;9(2):15-23.
Hoare MC. The role of primary varicose veins in venous ulceration. Comprehensive Vascular and Endovascular Surgery: Expert Consult. 1982;92:450-453.
Dur AHM, Mackaay AJC. Duplex assessment of clinically diagnosed venous insufficiency. Br J Surg. 1992;79:155-161.
Shankar KH. Clinical study of varicose veins of lower limbs. Internat Surg J. 2017;4(2):633-636.
Rudofsky G. Epidemiology and pathophysiology of primary varicose veins. Langenbecks Arc Chir. 1988;2:139-144.
O‘ Shaughnessy M, Rahall E, Walsh TN, Given HF. Surgery in the treatment of varicose veins. Ir Med J. 1989;82(2):54-55.
Bashir J, Das K, Ahuja P, Arain MS. Clinical features and risk factors of varicose veins at Liaquat University Hospital Hyderabad. Pak J Surg. 2013;29(2):127-130.
Sharma S, Pandey S, Bhatnagar A. Clinical study of 50 patients of varicose veins in NSCB Subharti Hospital, Meerut,(UP) with special reference to Clinical examination vs Color Doppler for evaluation and diagnosis of varicose veins. Inter J Scient Res. 2018;20;6(4).
Jami V, Kumar TP. A clinical study on varicose veins of lower limbs. Global J Res Analysis. 2018;7(6):75-77.
Copyright (c) 2021 JOURNAL OF SURGICAL ARTS / Cerrahi Sanatlar Dergisi
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.