Summary
Background: Viewing the literature, there exist no sufficient data from large multi-center studies in order to evaluate the short and long-term results following high saphenofemoral ligation and stripping (SFL/S) of the great saphenous vein (GSV). On the contrary, comparing to the ample data from numerous studies and registries concerning the endovenous procedures, the data for SFL/S are quite heterogeneous and incoherent.
Method: In a multicenter study (12 centers), 841 patients (1 070 extremities) with primary varikosis of the GSV underwent a high saphenofemoral ligation and stripping operation according to a strictly standardized operation procedure. Primary endpoint is the haemodynamic significant recurrence at the saphenofemoral junction (SFJ), defined as a vein in the SFJ area with a diameter >5mm, connected with the femoral vein and showing reflux >0,5s. Secondary endpoints are recurrent veins in the SFJ area connected to the femoral vein smaller than 5 mm (ultrasonographic recurrence), new varicose veins according to the REVAS classification and surgical morbidity. The patients underwent clinical and colour duplex ultrasonography reexaminations after 7 to 14 days, 3 to 4 months and thereafter on a yearly basis.
Results: New varicose veins were found in 1,1 % after 3-4 months and 6,4 % after one year. Ultrasonographic recurrence in the SFJ occurred after 3 to 4 months in 0,53 % and after one year in 2,24 %. Only two patients (0,29 %) presented one year after surgery with a haemodynamic significant recurrence at the SFJ (diameter >5mm).
Conclusion: The recurrence rate of the standardized SFL/S one year after surgery is very low.
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Keywords
High ligation - groin recurrence - multicenter study
