Evaluation of 1,197 Patients Treated with Outpatient-based Varicose Vein Stripping

Abstract

We evaluated 1,704 legs of 1,197 patients after treatment using an outpatient-based procedure for stripping lower extremity varicose veins in our hospital during the last 5 years (large saphenous vein stripping in 1,307 legs and small saphenous vein stripping in 397 legs). We used two local anesthetic agents concomitantly with intravenous Propofol. The principle treatment was a selective stripping using complete high-position ligation, removal of the reflux portions of the saphenous vein, and adjunctive varicose phlebectomy. We allowed patients to return home after one hour of bed rest postoperatively. While there were no manifestations of anesthetic toxicity, propofol induced premature ventricular contracture in two cases, forcing us to switch over to general anesthesia. Operative complications included hemostatic difficulty in 3 patients and postoperative bleeding in 1 patient who had been receiving an antiplatelet agent. The patient with postoperative bleeding required immediate retreatment, and remittance was achieved after hematoma removal. Wound infection was observed in 6 legs (0.35%), all of which were completely resolved by outpatient treatment. Saphenous nerve disorder was observed in only 59 legs (4.5%). Even in the patients who had undergone full-length stripping, the prevalence of saphenous nerve disorder was only 8.8%. This low prevalence may have been largely due to the efficacy of the local anesthesia in facilitating intra-adventitial dissection. No severe complications such as deep vein thrombosis or pulmonary infarction were observed.