Prevention Of Saphenous Nerve Injury By Segmental Stripping Of Superficial Veins From Varicose Veins Of Lower Extremities

ObjectiveBy comparing the severity of saphenous nerve injury(SNI)in lower extremity patients with varicose veins by segmental stripping of superficial veins with that of traditional stripping of whole veins,we concluded that the lower extremity varicose veins with less saphenous nerve injury were treated by surgical method,which provided a guide for the clinical operation of lower extremity varicose veins.MethodsAccording to the inclusion and exclusion criteria,91 patients with varicose veins of lower extremities in the First People’s Hospital of Yinchuan City from January 2018to June 2018 were randomly divided into the control group and the experimental group.46patients in the control group(group A)underwent traditional GSV high ligation+full-segment stripping.In the experimental group,45 patients(group B)underwent GSV high ligation+segmental stripping.the number of patients with saphenous nerve injury(SNI)symptoms such as numbness,pain,abnormal sensation and ant walking were recorded at 14days and 6 months after operation respectively.The CEAP(Clinical,Etiology,Anatomy,Pathology)grade and venous clinical severity score(VCSS)of patients before and 6 months after operation were recorded in detail.The number of saphenous nerve injuries was compared between the two groups 14 days and 6 months after operation.The improvement of CEAP and VCSS were compared before and 6 months after operation.The final data were analyzed with SPSS 19.0 statistical package.There was significant difference between the two groups as P<0.05,and the final conclusion was drawn.Results After 14 days of follow-up,20 patients had saphenous nerve injury symptoms during GSV total stripping,10 patients had saphenous nerve injury during GSV segmental stripping.After 6 months of follow-up,2 patients had saphenous nerve injury symptoms during GSV segmental stripping and 5 patients had saphenous nerve injury symptoms during GSVtotal stripping.Fourteen days later,the number of saphenous nerve injuries in two groups was examined byc~2tests,which showed significant difference(P<0.05).Six months after operation,the number of saphenous nerve injuries in group B and group A showed no significant difference(P>0.05).The CEAP and VCSS scores of the two groups at 6 months after operation were lower than those before operation.The VCSS scores of the two groups were compared before and 6 months after operation,showing no significant difference(P>0.05).There was no recurrence of varicose veins in lower extremities in the follow-up of the two groups 6 months after operation.Conclusion1.Sublevel stripping of GSV for varicose veins of lower extremities can significantly reduce the incidence rate of SNI in the near future,and sublevel stripping of great saphenous veins will not affect the recurrence of varicose veins after operation,which is worthy of clinical promotion.2.High ligation+segmental dissection of great saphenous vein and high ligation+total dissection of great saphenous vein can treat varicose veins of lower extremities very well.There is no difference between the two surgical methods in the treatment of patients with varicose veins.