Conventional Versus Invaginated Stripping of the Great Saphenous Vein: A Randomized, Double-Blind, Controlled Clinical Trial

BACKGROUND: 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. METHODS: Ninety-two patients were randomized for conventional (CON) or invaginated (INVAG) stripping and were followed for 26 weeks postoperatively. RESULTS: 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). CONCLUSION: Invagination of the GSV in uncomplicated primary varicosis may be associated with less surgical trauma compared to a conventional stripping technique.