Persistent popliteal fossa reflux following saphenopopliteal disconnection.
BACKGROUND
This was a retrospective assessment of the technical adequacy of saphenopopliteal disconnection (SPD).


METHODS
Patients scheduled for SPD underwent preoperative colour-coded duplex imaging to localize the saphenopopliteal junction (SPJ). Operations were conducted with the patients under general anaesthesia in the prone position with planned full popliteal fossa exposure. Patients were reimaged 6 weeks after operation.


RESULTS
Some 69 patients had surgery over 4 years; complete data were available for 59 (27 men and 32 women, median age 55 (range 27-78) years). There were eight staged bilateral procedures. Postoperative duplex scans identified 23 (39 per cent) with ideal results (incompetent SPJ successfully disconnected), 12 (20 per cent) with satisfactory results (incompetent SPJ disconnected successfully but persisting venous reflux in superficial veins), eight duplex failures (14 per cent) (previously identified incompetent SPJ persisted but was competent after operation) and 13 surgical failures (22 per cent) (incompetent SPJ completely missed during surgery). There were three major postoperative complications (5 per cent) (two deep vein thromboses and one popliteal vein injury) and one patient suffered a sural nerve palsy.


CONCLUSIONS
Despite preoperative duplex localization of the SPJ, SPD proved an unreliable technique in this series.
Rashid
H I
HI
Kent and Sussex Hospital, Mount Ephraim, Tunbridge Wells TN4 8AT, UK.
Ajeel
A
A
Tyrrell
Mark R
MR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*