Background: Varicose veins are a common condition affecting the lower limbs. Apart from having cosmetic problem, if not treated in time it can have some serious complications and are difficult to treat. Multiple modes of surgical management exist for the disease.Methods: This is a prospective clinical study, done over a period of 5-years, from February 2015 till February 2020. Patients were divided into 2 groups: group I (n=103) included those who underwent open surgical treatment with venous stripping. Group II (n=104) included those who subjected to Radiofrequency ablation (RFA). Groups were selected with comparable physical parameters. Various parameters like bleeding, hematoma, blood requirement, postoperative inflammation, pain, numbness, mobilization, date of discharge and resuming duties were compared. All patients were followed up for 1year.Results: Majority of our patients belongs to age group 20-40 years with mean age of 35year in both groups. Male has dominance over female with male to female ratio 4:1. Noticed significant complication in group I than group II, such as bleeding (20:1), hematoma (5:0), inflammation (60:1) and blood requirement (1:0). In group II, noticed early mobilization of patient (1day v/s 3 days), discharge from hospital (1day v/s 5 days) and resuming duties (5 days v/s 2 weeks).Conclusion: RFA keeps an edge over open surgical treatment with venous stripping.
Introduction: Sympathectomy is used principally in patients of inoperable peripheral vascular disease, small vessel disease, and vasospastic disease. It is useful to alleviate symptoms of rest pain and as an adjunct to heal ischemic ulcers. Aim and Objective: This is a clinical study to evaluate the role of sympathectomy in postvascular surgical patients with persistent pain in distal limb (causalgia) with or without ischemic ulcers on the foot or hand. Materials and Methods: This study was performed between February 2015 and February 2020. We did 823 arterial surgical interventions including embolectomies, endarterectomy with patch arterioplasty, and interposition grafting in upper or lower limb vessels. These patients were diagnosed on clinical bases and with investigational modalities such as arterial Doppler study and computed tomography angiography. All these patients had chronic vascular obstruction. Out of them, we selected 54 patients having persistent pain distal limb (causalgia) not relieved by medications. Besides causalgia, 24 patients had ischemic ulcers either on foot or hand. Postoperative arterial Doppler study was satisfactory in these patients. Their complaint persisted for 3–4 months in spite of all medications. Chemical sympathectomy was tried in 21 patients but was ineffective. We did thoracic sympathectomy in 28 patients and lumbar sympathectomy in 26 patients on side affected. Observation and Results: There were 46 males and 8 females. Majority of these patients were in active phase of life with a mean age of 35 (±2). Pain was relieved in all patients. Ischemic ulcers present in 24 patients also healed within 3–6 weeks. Conclusion: Although no clear guidance exists for the role of sympathectomy in postsurgical patients, we observe it is a boon for postvascular surgical patients with persistent pain and small ischemic ulcers.
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