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

Samuel, Nehemiah; Carradice, Daniel; Wallace, Tom; Smith, George E.; Mazari, Fayyaz; Chetter, Ian

doi:10.1258/phleb.2011.011063

Cited by 8 publications

(11 citation statements)

References 31 publications

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“…Tong and Royle [ 4 ] previously reported that recurrence was attributed to an intact incompetent SPJ in 28% of 70 cases of recurrent varicose veins following SSV surgery. However, other studies have shown that flush ligation of the SPJ by formal exploration of the popliteal fossa did not appear to affect outcomes [ 7 ] and was associated with major complications [ 11 , 12 ]. Rashid et al [ 12 ] reported a low technical success rate (59%) after formal SPJ dissection, with three major complications occurring, including DVT and tearing of the popliteal vein.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the 2-cm angled segment was left untreated for two reasons: (1) preservation of the gastrocnemius veins that enter into this segment, and (2) because the tibial nerve enters into close proximity with the SSV at this deeper level. In the literature, clinical recurrence of SSV varicose veins after surgical treatment has been reported to range from 8.6% to 30% [ 7 , 11 , 13 , 14 ]. The most common cause of recurrence after surgical treatment of the SSV is neovascularization [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

Hong

2015

Korean J Thorac Cardiovasc Surg

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BackgroundThe aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities.MethodsBetween January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications.ResultsNo major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases.ConclusionIn the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

Hong

2015

Korean J Thorac Cardiovasc Surg

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“…Die hohe Quote nachweisbarer Parvastümpfe ist ein Beleg dafür, dass keine korrekte saphenopopliteale Ligatur vorgenommen wurde. Von der einfachen subfaszialen Parvaligatur [5,6] bis zur saphenopoplitealen Ligatur [27,31,34] ist alles vertreten. In der Arbeit von Allegra et al [1] mit 30 % Kros-senrezidiven nach 5 Jahren ist überhaupt keine OP-Technik angegeben.…”

Section: Kohortenstudie Zur Parvakrossektomieunclassified

Crossectomy (flush ligation) of small saphenous vein

Stenger¹,

Hartmann²

2020

Phlebologie

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A correct crossectomy of the small saphenous vein, as stipulated by Hach and Mumme, is seldom carried out in literature. The two authors thoroughly describe the technical procedure of a high, flush ligation of the saphenopopliteal junction (SPJ). The risks and problems of the surgery are described and illustrated.A retrospective cohort study with the aim of conducting a flat small saphenous crossectomy yielded the following findings in 187 operated legs: small saphenous remainder stumps with clinically relevant recurrence in 2.1 %, small saphenous neovasculature with clinically relevant recurrence in 1.1 %, junction stump or neovasculature without clinically relevant recurrence in 1.6 % of cases. In summation, the total amount of actual recurrences was 4.8 %.

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“…Die sehr umfangreiche Arbeit von Brittenden et al basiert auf den Ergebnissen der in Großbritannien und Nordirland durchgeführten Untersuchungen. Diesbezüglich darf auf die Problematik der oben aufgelisteten Untersuchungen von Winterborn et al [54], Rashid et al [40] und Samuel et al [44] verwiesen werden. Eine korrekte Parvacrossektomie wird nicht oder zumindest sehr selten (10 % in der Analyse von Winterborn et al durchgeführt).…”

Section: Ergebnisse Der Endoluminalen Behandlungunclassified

Die Chirurgie der Vena saphena parva – endoluminal oder operativ

Stenger¹,

Hartmann²

2019

Phlebologie

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ZusammenfassungBislang existiert kein einheitlicher Standard in der operativen oder endovenösen Therapie der Parvainsuffizienz. Daher ist eine direkte Vergleichbarkeit operativer und endovenöser Verfahren bislang nur eingeschränkt möglich. Insbesondere erschweren unterschiedliche Definitionen eines Rezidivs die Vergleichbarkeit der unterschiedlichen Therapieoptionen. Prospektive randomisierte Studien zu den Langzeitergebnissen fehlen. Aufgrund der schwachen Datenlage sind grundsätzliche Empfehlungen für oder gegen die eine oder andere Therapieoption derzeit nicht möglich. Dennoch gibt es in der täglichen Praxis eindeutige Vorteile für die Operation oder für die endovenöse Therapie, auch wenn entsprechende Vergleichsstudien fehlen. Die Rezidivraten sind sowohl bei operativer- als auch bei endovenöser Behandlung hoch. Allerdings wird weder bei der Operation, noch bei der endovenösen Therapie eine komplette Ausschaltung der krankhaft veränderten Vene vorgenommen. Zukünftige Studien sollten klären, inwieweit die komplette Ausschaltung der Parvacrosse mit Umsetzung des Prinzips der Crossektomie zu einer Verbesserung der Ergebnisse beitragen kann.

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

Cited by 8 publications

References 31 publications

Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

Crossectomy (flush ligation) of small saphenous vein

Die Chirurgie der Vena saphena parva – endoluminal oder operativ

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