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Mariani F. 1, 2, Bucalossi M. 1, 2
1 Department of General Surgery University of Siena, Siena, Italy
2 The Compression Therapy study Group (CTG) Colle Val d’Elsa, Siena, Italy
Aim. The aim of this study was to analyze the recurrence incidence at five-year follow-up on patients who underwent a selective crossectomy of the great saphenous vein, considering the importance of collateral veins of junction and demonstrating that groin recurrence are not dependent on complete crossectomy, as supported by traditionalists.
Methods. Five-hundreds and twelve patients were treated from January 2002 to December 2006 (370 females and 142 males). Mean age was 60 years. All the patients underwent a selective crossectomy made by a sole operator, in day-surgery and with local anaesthesia regimen. The study randomized 150 of these patients. All of them underwent clinical venous examinations of the lower limbs and a color Doppler, made by an independent operator at different times after the operation.
Results. Out of 150 patients controlled with color-Doppler only one presented with groin recurrence (0.6% of the patients) own to a technique mistake of the operator. The patient underwent, in fact, a selective crossectomy in December 2002, on the left anterior lateral thigh vein, that leads as common trunk together with the external iliac circumflex vein.
Conclusion. On the basis of the present clinical experience it is possible to notice how the internal selective crossectomy, saving the tributary veins coming from the abdominal wall, together with the most convenient treatment of saphenous insufficiency, is an efficacious therapy, gives results of undoubtable validity both from the prognostic point of view and considering the rate of groin recurrences in five years.