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Changes in Transmission of Lower Limbs Nerves After Varicose Veins Operations with Saphenous Vein Stripping

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Oszkinis G., Jaworucka-Kaczorowska A., Huber J., Kaczorowski P., Wiertel-Krawczuk A., Pukacki F., Zieliński M., Snoch M., Majewski W.
Polish Journal of Surgery
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2008
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vol. 80
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issue 8
404-412
EN
The injury of the lower limb nerves is a very frequent complication after the varicose veins surgical treatment. The stripping of the great saphenous vein can cause the lesion of saphenous nerve and other lower limb nervesThe aim of the study was to establish the relationship between the percentage of the nerve injuries at the long stripping of great saphenous vein and to estimate the impact of this surgical treatment on the quality of patient's life.Material and methods. The neurophysiological examinations which included 80 patients were performed four times- before the operation, 2 weeks, 3 and 6 months after the operation. The following neurophysiological examinations were used: the sensory conduction velocity studies (SCV), the intensity of current-stimulus duration curves (IC-SD) and the von Frey filaments examination, the electroneurography (ENG, M-wave studies) and electromyography (EMG). The questionnaire to estimate the quality of life among the patients after the varicose veins operations was also conducted.Results. 30 patients (36%) were found to be injured with the saphenous nerve. These disorders persisted among 17 patients (21.25%) 3 months and among 11 patients (13.75%) 6 moths after the operation. In 38 patient (47.5%) 2 weeks after the operation, 24 of patients (30%) 3 months after the operation and in 15 patients (18.75%) 6 months after the operation showed the abnormalities which were usually located near the medial ankle. The paraesthesia which occured among 32 patients (40%) did not worsen the quality of life and only one patient wouldn't agree to repeated operation. In 6 patients (7.5%) there was found hyperaesthesia which had the significantly bad impact on patient's life and 5 of them (83.33%) wouldn't agree to such an operation once again. There were also observed the temporary disorders of the tibial nerve (7 patients - 8.75%) and the peroneal nerve (17 patients - 21.25%).Conclusions. The varicose veins operations have the significantly bad influence on the saphenous nerve transmission and can cause a transient injury of the tibial and peroneal nerves. The sensory disorders usually concern the region of the medial ankle. The operation doesn't significantly worsen the patient's quality of life but the sort of sensory disorders has the influence on patient's estimation.
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