Closure of the saphenous opening after saphenofemoral junction disconnection: An anatomical barrier against postoperative neovascularization

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2 Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Introduction: Neovascularisation at the sapheno-femoral junction (SFJ) ligation site in the groin may occur within one year after great saphenous vein (GSV) surgery. Several anatomical and  prosthetic  barrier  techniques  have  been  proposed  to  prevent  this  evolution.
Aim: To test the hypothesis that the construction of an anatomical barrier by simple closure of the saphenous opening might decrease the incidence and extent of postoperative neovascularisation at the SFJ.
Patients and methods: From October 2006 to October 2008, we included 112 patients with
130 limbs presenting with primary varicose veins. The test (group A) patients, had the edges of the saphenous opening closed after SFJ disconnection. Follow up was done by duplex scan to detect neovascular serpentine veins at the groin.
Results: Our patients mean age was 30.2 years. According to preoperative CEAP classification we had 76 limbs classified as C2, and 54 limbs classified as C3. Both groups were initially matched regarding the venous disability score (VDS). There was a significant difference (p=0.025) between the 2 groups at 1 year duplex follow up with 2 patients in the test group (group A) with groin   neovascularization   versus   12   patients   in   the   control   group   (group   B).
Conclusion: This study suggests a potential benefit of closure of the saphenous opening after SFJ ligation in the groin, a technique applied to contain postoperative neovascularisation at the ligated GSV stump.

Keywords

Ain Shams Journal of Surgery
Volume 3, Issue 1
January 2010
Pages 55-62

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