[How to prevent saphenous nerve injury. A personal modified technique for the stripping of the long saphenous vein].
BACKGROUND
In literature the incidence of paresthesia caused by long stripping (LS) of the saphenous vein (SV) varies widely. Best results have been reported with the invagination technique by Van Der Stricht. However, this technique is associated with a high incidence of vein rupture and incomplete stripping. The aim of this study is to test a personal technique to avoid the SV rupture and to reduce the incidence of saphenous nerve injury.


METHODS
Sixty-eight patients underwent LS of the SV from groin to ankle under monolateral spinal anesthesia on a one-day surgery basis using a personal technique combining external and invaginated saphenous stripping. All patients underwent a clinical re-evalutation 1, 3, 6, 12, 24 and 48 months after the operation.


RESULTS
No intraoperative complications were recorded. Stripping of the long saphenous vein was complete in all cases without any rupture of the veins. Only one postoperative hematoma of the leg (1.5%) which was naturally reabsorbed, was recorded; four patients (5.9%) had transitory saphenous nerve injury. Permanent saphenous nerve damage was found in only one of 68 patients (1.5%). All the patients were discharged on the day of operation and we did not register any prolonged hospitalization.


CONCLUSIONS
The result of our approach was a very low postoperative complication rate (1.5% of permanent neurological damage) without any rupture of the vein.
Sorrentino
P
P
Azienda Ospedaliera, Dipartimento Scienze Medico-Chirurgiche, Clinica Chirurgica 4, Università degli Studi di Padova, Padova, Italy. p.sorrenti@libero.it
Renier
M
M
Coppa
F
F
Sarzo
G
G
Morbin
T
T
Scappin
S
S
Baccaglini
U
U
Ancona
E
E
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008875:Middle Aged; D059348:Peripheral Nerve Injuries; D011183:Postoperative Complications; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D014689:Venous Insufficiency / Q000601:surgery
Come prevenire le lesioni del nervo safeno. Una tecnica personale modificata per lo stripping della grande safena.