Clinical Features and Surgical Management of Varicose veins of Lower limbs

Introduction: Varicose veins are a common clinical condition affecting the lower limbs. Usually patient comes for a cosmetic problem, it can cause complications giving rise to significant morbidity if not treated in time. Different options are available for surgical management. The present study has been carried out to study demographic factors, evaluate clinical presentation and outcome of various modalities of management of varicose veins of lower limb. Material and Methods: This is a prospective, descriptive and observational study conducted at Department of General Surgery, Pt. Jawahar Lal Nehru Government Medical College and Hospital Chamba Himachal Pradesh. Seventy cases admitted and operated from all the surgical units during the period of 2018 April to September 2019 were studied. All the patients presenting with varicose veins of lower limb, which met the inclusion and exclusion criteria were selected for this study. Results: In our study, maximum number of patients were in 18-30 years and predominant were male. In this series, 37 patients had varicosity in the left lower limb and 29 had varicosity in the right lower limb and the remaining 4 had bilateral limb involvement. Among them prominent veins and pain were the main complain in 56 (80%) patients. Itching and pigmentation were present in 6 (8.5%) patients. Ankle edema was present in 5 (7.1%) patients. Pain and ulceration of lower leg were present in 3 (4.2%) patients. Out of 70 cases studied, 32 (45.7%) had only long saphenous vein, 10 (14.3%) had short saphenous vein and in 9 (12.8%) cases both short and long saphenous were involved. In addition to long saphenous vein, incompetent perforators were present in 19 (27.2%) cases. Conclusion: Varicose veins are commonly seen in males, maximum in the age group of 18-30 years. Most common presenting symptom is visible dilated veins over lower limb but more than half of the patients present with one or more complications. Most commonly venous system involved is great saphenous vein system and most commonly involved perforators are below knee perforators. If cases are selected properly with good operative technique the complications are negligible. This surgical procedure followed enable the patients to lead almost a normal life.