Primary surgery for sapheno-femoral incompetence: A randomised controlled trial to compare two techniques to reduce lymphatic complications.
BACKGROUND
We prospectively compared lymphatic complications after two types of surgery for primary sapheno-femoral incompetence: sharp dissection with meticulous ligation of lymphatic tissue and electrocoagulation technique respectively.


METHODS
154 consecutive patients undergoing surgery for bilateral primary sapheno-femoral incompetence were randomised. Each side was the control for the other side. 154 groins underwent sharp dissection with ligation of lymphatic tissue using absorbable suture material and 154 controls had a dissection performed with electrocoagulation.


RESULTS
There was no lymphocoele, no relevant lymphorrhea and no extremity oedema in either group. Three patients had a minor lymphatic discharge in both groins, self-limiting within 24 hours (1.9%). There were no significant differences between the two groups.


CONCLUSIONS
Lymphatic complications in primary surgery for sapheno-femoral incompetence are very rare. There is no detectable advantage of sharp dissection with ligation of lymphatic tissue over dissection with electrocoagulation without ligatures.
Mouton
W G
WG
Department of Surgery, Spital Thun STS AG, Thun, Switzerland. wolfgang.mouton@spitalthun.ch
Keller
S
S
Naef
M
M
Wagner
H E
HE
D000328:Adult; D000368:Aged; D004487:Edema / Q000209:etiology / Q000517:prevention & control*; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D005268:Femoral Vein / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008210:Lymphocele / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D012501:Saphenous Vein / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000503:physiopathology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*; D014689:Venous Insufficiency / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult