Proportion of Nontransient Postoperative Saphenous Neuralgia in Patients Undergoing Varicose Vein Surgery

Introduction: Chronic venous insufficiency is common in India. The available modalities of conventional treatment include high ligation and stripping (HL + S) and endovenous ablation. A common drawback stated for HL + S is the possibility of saphenous nerve neuralgia postoperatively. Objectives: The objective of this study was to determine the perceived disability and proportion of nontransient postoperative saphenous neuralgia in patients undergoing conventional surgery. Methodology: A study of patients admitted for conventional surgery (ligation and stripping of the saphenous vein, hook phlebectomy, and foam sclerotherapy) under the Department of General Surgery was conducted over 12 months. At 3-month follow-up, postoperative neurological deficits or symptoms, if any, were assessed using a questionnaire to assess qualitative variables and neurological examination for sensory deficits. Severity of symptoms in the pre- and postoperative period was described and compared using the Venous Clinical Severity Score. Results: Twelve out of the 80 patients were found to have postoperative saphenous neuralgia. Eight of the 12 patients had minimal symptoms, whereas one had moderate symptoms. The remainder did not have any disconcerting effects on the quality of life. The duration of symptoms was 3 months for only one person. The others had only transient saphenous neuralgia and the symptoms had resolved by 3 months. Conclusion: Our study shows that the severity and duration of the saphenous neuralgia, if present, are minimal. Hence, this surgery is still a good alternative to thermal ablation in resource-poor settings or if the patient cannot afford the costs of newer modalities of varicose vein surgery.