Conventional versus invaginated stripping of the great saphenous vein: a randomized, double-blind, controlled clinical trial.

Abstract

An invaginated strip of the great saphenous vein (GSV) may be associated with diminished blood loss and less discomfort compared to conventional stripping in patients with unilateral primary GSV varicosis. Ninety-two patients were randomized for conventional (CON) or invaginated (INVAG) stripping and were followed for 26 weeks postoperatively. Both groups (n = 46) were well balanced for age, gender distribution, and body mass index. The CON group lost twice as much blood compared to the INVAG group (CON: 28 +/- 4 g, INVAG: 15 +/- 2 g, p < 0.001). Infragenual incision length following a conventional strip was twice as long (CON: 16 +/- 1 mm, INVAG: 8 +/- 1 mm, p < 0.001). Pain as measured with a visual analog scale (minimal 0, max 10) decreased in both groups in a similar fashion from 3.2 +/- 0.3 preoperatively to 0.6 +/- 0.2 after 26 weeks (p < 0.001). Saphenous nerve damage after one month was observed in four CON patients compared to no patients following invagination. Return to work was not different (CON: 13 +/- 2 days, INVAG: 11 +/- 2 days). Invagination of the GSV in uncomplicated primary varicosis may be associated with less surgical trauma compared to a conventional stripping technique.