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Abstract

Objectives: To evaluate the epidemiological aspects andfeasibility of varicose veins surgery as a day case procedure in all patients of primary varicose veins and toidentify the risk factors for hospital admission. Design: Interventional with prospective observational study.Place & Duration: This study was conducted from Nov 1999 to Oct 2003 at the department of Surgery B VHospital Bahawalpur. Patients& Methods: Fifteen patients, 1 female and 15 male of varicose veins attendingthe surgical outdoor fulfilling the inclusion criteria and requiring varicose veins surgery underwent theirprocedure performed as a day case. A standard technique of sapheno femoral ligation with stripping of the longsaphenous vein to just below knee and multiple stab avulsions of varicosities after subfascial ligation of theperforators was performed. All cases were reviewed postoperatively for eight weeks. Results: All fifteen patientsunderwent varicose vein surgery, of whom 33% had bilateral varicosities and all had primary varicose veins. Thecommon presentation of all patients (80%) was heaviness, leg fatigue and dull pain in the calves during walking.Six (40%) patients had hyper-pigmentation with leg edema. 33.3% varicose ulcers and 13.4% bleedingvaricosities with dermatosclerosis or / and eczematoid dermatitis while the remaining 13.4% patients hadasymptomatic varicosities. Three patients (20%) developed postoperative complications. Ten 66.67% patientswere discharged on the day of surgery while remaining 5 patients (33.34%) required admission due to minoranaesthetic complications and patient’s preference, among whom two (13.4%) required admission for more than24 hours. The need for over night admission was associated with the age of the patients, bilateral varicose veinsurgery and the use of spinal anaesthesia. Conclusion: Although varicose vein surgery is safe, acceptable andcost effective as a day case or ambulatory surgical procedure, if attempted in all patients, overnight admissionwill be required in a significant proportion. Preoperative selection of the patients is mandatory to achieveoptimal results.