The impact of direction of great saphenous vein total stripping on saphenous nerve injury

• Published in: Phlebology Vol. 29; no. 1; p. 52
• Main Authors: Papakostas, J C, Douitsis, E, Sarmas, I, Avgos, S, Kyritsis, A, Matsagkas, M
• Format: Journal Article
• Language: English
• Published: England 01.02.2014
• Subjects: Adult; Electrophysiology; Female; Humans; Incidence; Leg - pathology; Male; Middle Aged; Peripheral Nerve Injuries - etiology; Peripheral Nerve Injuries - physiopathology; Peripheral Nervous System Diseases - etiology; Saphenous Vein - innervation; Saphenous Vein - surgery; Time Factors; Trauma, Nervous System - etiology; Treatment Outcome; Varicose Veins - complications; Varicose Veins - surgery; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - methods; varicose surgery complications; stripping direction; great saphenous vein; saphenous nerve; electrophysiological nerve studies
• ISSN: 1758-1125
• DOI: 10.1258/phleb.2012.012061

To examine and compare the effects of downwards versus upwards total stripping of great saphenous vein (GSV) on saphenous nerve (SN) injury using clinical and electrophysiological studies. Fifty patients with varicosities were equally and randomly assigned to undergo total, upwards stripping (group A) or downwards stripping (group B) of GSV during saphenectomy. SN function was measured with electroneurogram (ENG) before operation, two weeks and 12 weeks after, in order to record the incidence and type of SN injury. Clinical signs of SN injury were also recorded at the same time points. The results were statistically analysed. There were no statistical significant differences on the occurrence of SN injury between groups A and B at two and 12 weeks, respectively, as confirmed with ENG studies and clinical evaluation. There were no differences between the two techniques with regard to the type of SN injury. SN injury was significantly ameliorated from 34% to 6% during the first three months. SN injury was equally observed after downwards or upwards total stripping of the GSV, as confirmed by ENG and clinical evaluation, with no differences in injury type. SN injury tends to be relieved through time in most patients.