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Is saphenofemoral junction reconstruction necessary during stripping of the saphenous vein?
Surgery. 2006 May; 139(5):640-5.S

Abstract

BACKGROUND

Patients who had undergone complete ankle-to-groin stripping of the greater saphenous vein were evaluated retrospectively to assess the necessity of saphenofemoral junction reconstruction during the stripping procedure. Since 1996, in addition to the conventional complete stripping operation, we routinely perform a saphenofemoral junction reconstruction in patients presenting with greater saphenous vein reflux associated with low-grade (grades I-II) saphenofemoral junctional reflux. In this method, the size of the common femoral vein was adjusted to the desired diameter by a running linear suture technique after division of the greater saphenous vein.

METHODS

Retrospective evaluation revealed that 73 limbs in 56 patients treated with this technique (group I). This group of patients was matched to another group of 65 patients (78 limbs) with similar characteristics and symptoms (group II) in whom the conventional complete ankle-to-groin stripping of greater saphenous vein was the treatment. The 2 groups were compared with respect to the incidence of complications, including recurrence of varicosities, ecchymosis, lymphocele, lymphorrhagia, wound infection, and paresthesia in the operated extremity. All patients also were evaluated by Doppler ultrasonography at 6 months, 12 months, and annually thereafter to determine the saphenofemoral junction reflux time (valve reflux time). The mean duration +/- SD of follow-up was 6.7 +/- 1.6 years (range, 2.1-10.8 years).

RESULTS

Recurrence of varicosity was noted in 14 patients, 3 in group I and 11 in group II (P = .02). There were no statistically significant differences between the 2 groups in terms of ecchymosis, hematoma, lymphocele, lymphorrhagia, wound infection, and paresthesia. At 6 months, a rapid decrease in valve reflux time was noted in group I (P = .0001). In addition, there was a significant improvement in valve reflux time at each subsequent Doppler examination in group I. Group II showed a decrease in valve reflux time, compared with the preoperative value (P = .068). During subsequent Doppler examinations, a decrease in valve reflux time also was noted in group II; this difference reached statistical significance only at 24 months (P = .04).

CONCLUSIONS

We believe that saphenofemoral junction reconstruction is a simple technique to perform and that addition of this method to the conventional stripping provides more durable results with a lesser incidence of recurrence. This method should be considered as a treatment modality in patients with greater saphenous vein reflux associated with low-grade (grades I-II) saphenofemoral junctional reflux.

Authors+Show Affiliations

Cardiovascular Surgery Department, Turkey. melihus@superonline.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16701097

Citation

Hulusi, Melih, et al. "Is Saphenofemoral Junction Reconstruction Necessary During Stripping of the Saphenous Vein?" Surgery, vol. 139, no. 5, 2006, pp. 640-5.
Hulusi M, Ozbek C, Basaran M, et al. Is saphenofemoral junction reconstruction necessary during stripping of the saphenous vein? Surgery. 2006;139(5):640-5.
Hulusi, M., Ozbek, C., Basaran, M., Ucak, A., Sanioglu, S., Arslan, Y., Ogus, T., Kaya, K. Z., & Yilmaz, A. T. (2006). Is saphenofemoral junction reconstruction necessary during stripping of the saphenous vein? Surgery, 139(5), 640-5.
Hulusi M, et al. Is Saphenofemoral Junction Reconstruction Necessary During Stripping of the Saphenous Vein. Surgery. 2006;139(5):640-5. PubMed PMID: 16701097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is saphenofemoral junction reconstruction necessary during stripping of the saphenous vein? AU - Hulusi,Melih, AU - Ozbek,Cihan, AU - Basaran,Murat, AU - Ucak,Alper, AU - Sanioglu,Soner, AU - Arslan,Yucesin, AU - Ogus,Timucin, AU - Kaya,Kaya Zafer, AU - Yilmaz,Ahmet Turan, PY - 2005/03/28/received PY - 2005/09/11/revised PY - 2005/09/11/accepted PY - 2006/5/17/pubmed PY - 2006/6/24/medline PY - 2006/5/17/entrez SP - 640 EP - 5 JF - Surgery JO - Surgery VL - 139 IS - 5 N2 - BACKGROUND: Patients who had undergone complete ankle-to-groin stripping of the greater saphenous vein were evaluated retrospectively to assess the necessity of saphenofemoral junction reconstruction during the stripping procedure. Since 1996, in addition to the conventional complete stripping operation, we routinely perform a saphenofemoral junction reconstruction in patients presenting with greater saphenous vein reflux associated with low-grade (grades I-II) saphenofemoral junctional reflux. In this method, the size of the common femoral vein was adjusted to the desired diameter by a running linear suture technique after division of the greater saphenous vein. METHODS: Retrospective evaluation revealed that 73 limbs in 56 patients treated with this technique (group I). This group of patients was matched to another group of 65 patients (78 limbs) with similar characteristics and symptoms (group II) in whom the conventional complete ankle-to-groin stripping of greater saphenous vein was the treatment. The 2 groups were compared with respect to the incidence of complications, including recurrence of varicosities, ecchymosis, lymphocele, lymphorrhagia, wound infection, and paresthesia in the operated extremity. All patients also were evaluated by Doppler ultrasonography at 6 months, 12 months, and annually thereafter to determine the saphenofemoral junction reflux time (valve reflux time). The mean duration +/- SD of follow-up was 6.7 +/- 1.6 years (range, 2.1-10.8 years). RESULTS: Recurrence of varicosity was noted in 14 patients, 3 in group I and 11 in group II (P = .02). There were no statistically significant differences between the 2 groups in terms of ecchymosis, hematoma, lymphocele, lymphorrhagia, wound infection, and paresthesia. At 6 months, a rapid decrease in valve reflux time was noted in group I (P = .0001). In addition, there was a significant improvement in valve reflux time at each subsequent Doppler examination in group I. Group II showed a decrease in valve reflux time, compared with the preoperative value (P = .068). During subsequent Doppler examinations, a decrease in valve reflux time also was noted in group II; this difference reached statistical significance only at 24 months (P = .04). CONCLUSIONS: We believe that saphenofemoral junction reconstruction is a simple technique to perform and that addition of this method to the conventional stripping provides more durable results with a lesser incidence of recurrence. This method should be considered as a treatment modality in patients with greater saphenous vein reflux associated with low-grade (grades I-II) saphenofemoral junctional reflux. SN - 0039-6060 UR - https://www.unboundmedicine.com/medline/citation/16701097/Is_saphenofemoral_junction_reconstruction_necessary_during_stripping_of_the_saphenous_vein L2 - https://linkinghub.elsevier.com/retrieve/pii/S0039-6060(05)00549-0 DB - PRIME DP - Unbound Medicine ER -