Outcome following saphenopopliteal surgery: a prospective observational study

Ikponmwosa, A.; Bhasin, Nikhil; Weston, Mike; Berridge, David; Scott, D.

doi:10.1258/phleb.2009.009001

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…Our study, similar to results reported by Ikponmwosa et al , 19 clearly demonstrated the usefulness of preoperative duplex marking which facilitated in positively identifying the SPJ in all 50 limbs. This is in stark contrast to some of the studies that have reported no better outcomes with preoperative duplex marking.…”

Section: Discussionsupporting

confidence: 92%

Saphenopopliteal ligation and stripping of small saphenous vein: does extended stripping provide better results?

et al. 2012

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SPL with or without stripping is an effective procedure improving clinical severity and QoL in the short term. Early outcomes favour SPL with extended stripping to offer greater improvement in disease-specific QoL, venous severity and cosmesis. With this small sample, there is no evidence of increased complications following stripping, or increased short-term recurrence without it. Greater numbers and follow-up are required to make firm conclusions.

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Section: Discussionsupporting

confidence: 92%

Saphenopopliteal ligation and stripping of small saphenous vein: does extended stripping provide better results?

et al. 2012

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“…A more recent study by Ikponmwosa et al looked at the role of adjunctive pre-operative duplex skin marking given the anatomical variability of the SPJ. 30 In a total of 90 limbs, the authors found that the SPJ was successfully ligated in 87 (96.7%) cases. Reflux was completely abolished in 51 (56.7%) cases but persisted solely in the small saphenous vein (SSV) in 32.2%.…”

Section: Small Saphenous Vein Surgerymentioning

confidence: 97%

Is there a continuing role for traditional surgery?

Coughlin

Berridge

2015

Phlebology

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Despite recent NICE guidance there remains a definite role for surgery in the management of varicose veins. A lot of the available evidence that has driven the transformation of care towards endovenous treatments is of good quality yet published by enthusiasts. No endovenous studies have reported long term results as far out from intervention as the open studies, yet in the meta-analysis from Murad et al, the authors suggested from their results that when surgery was compared with all endoluminal ablation therapies, surgery was associated with a non-significant reduction in the risk of varicose vein recurrence (RR0.63; 95%CI 0.37--1.07). Much of the longer-term data on recurrence following open surgery for primary varicose veins dates back well over 15 years ago. This is prior to the inclusion of routine duplex assessment and sub-specialty designation. The recent Cochrane review (13 randomised controlled studies, 3081 patients). The overall conclusion was that UGFS, EVLT and RFA were at least as effective as surgery in the treatment of the LSV. This meta-analysis did not include the CLASS (Comparison of LAser, Surgery and foam Sclerotherapy as a treatment for varicose veins) trial in which measures of clinical success were similar among the groups. Only 48% of the patients screened were eligible for the CLASS study and of these, only 24% of the eligible patients agreed to take part in the study. Similarly in the study by Carradice out of a total of 772 patients assessed for suitability, 442 did not meet the inclusion criteria. There is no doubt that endovenous surgery will increasingly become first line treatment for patients with symptomatic superficial venous reflux specifically in patients with SSV reflux. However, given the device related limitations with endothermal techniques specifically with regard to adverse anatomical features allied to the poorer results of UGFS within the treatment of LSV reflux, there is without doubt still a role for more traditional open surgical techniques that can be delivered with good short and long term outcomes and still being delivered in a cost effective manner.

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“…A similar approach is recommended for the lesser saphenous vein with its anatomically quite variable junction, where again ligation should be performed as close as possible to the junction [4]. At the moment it is still unclear if the interruption of muscle veins at the saphenopopliteal junction is indicated and contributes to the prevention of recurrences.…”

Section: Classical Varicose Vein Surgerymentioning

confidence: 99%

Varicose vein surgery

Kendler

Fellmer

Wetzig

2012

J Deutsche Derma Gesell

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SummaryVenous diseases are common in the general population. After a comprehensive diagnostic evaluation, an individual therapeutic approach should be selected on the basis of the findings, with the aim of treating the diseased vein segments and improving quality of life. Numerous therapeutic options are available for the treatment of varicose veins. In addition to conservative methods such as compression therapy, exercise or drugs, surgical procedures such as traditional surgery, thermal ablation techniques or sclerotherapy can be performed. Recent developments include the use of endoluminal water vapor or mechano-chemical endovenous ablation.

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Outcome following saphenopopliteal surgery: a prospective observational study

Cited by 10 publications

References 19 publications

Saphenopopliteal ligation and stripping of small saphenous vein: does extended stripping provide better results?

Saphenopopliteal ligation and stripping of small saphenous vein: does extended stripping provide better results?

Is there a continuing role for traditional surgery?

Varicose vein surgery

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