Isolated great saphenous vein stripping for the treatment of varicose veins in lower limbs: a prospective study

Background: Endovenous techniques are considered the gold standard for treating great saphenous vein (GSV) insufficiency, but access remains limited in low- and middle-income countries. In such contexts, simplified conventional surgeries may represent viable alternatives. This study aimed to compare outcomes of isolated GSV stripping with conventional surgery (stripping plus varicose vein resection) in patients with varicose veins (VV) associated with GSV insufficiency. Methods: A prospective interventional study was conducted including 34 patients with VV (CEAP C2-C6), divided into two groups: Conventional (C, n=17) and Isolated Saphenectomy (IS, n=17). Quality of life was assessed preoperatively and at 2 and 6 months postoperatively using the Venous Clinical Severity Score (VCSS) and VEINES-QoL/Sym questionnaires. Varicose vein evolution in the IS group was quantified using a standardized visual scoring system. Statistical analyses included Students t-test, chi-square, and generalized estimating equations (p[&le;]0.05). Results: Both groups were demographically comparable. Surgical treatment significantly improved VCSS and VEINES scores in both groups (p<0.005), with no intergroup difference at 6 months. In the IS group, the mean reduction in visible VV was 46% (range 20-90%). CEAP classification improved in both groups, with migration toward less severe categories postoperatively. No major complications were reported. Conclusion: Isolated GSV stripping yields comparable short- and mid-term improvements in symptoms and quality of life to conventional surgery, while reducing operative extent. In resource-limited settings, this abbreviated technique may expand access to treatment for VV, improving patient outcomes and reducing healthcare costs without compromising clinical efficacy.