title: Selective high ligation of the sapheno-femoral junction decreases the neovascularization and the recurrent varicose veins in the operated groin.
abstract: OBJECTIVE
  High ligation (HL) and stripping of GSV can be distinguished in Babcock's radical ligation (RHL), and selective (SHL): the new technique consists to ligate the SFJ keeping some of the tributary veins. The study analyzes the neovascularization and recurrence incidence in the groin after the SHL.
  
  
  METHODS
  A retrospective study performed in a center specialized in venous surgery in Italy, it included 360 patients underwent unilateral varicose vein surgery from January 2001 to December 2008 (210 females and 150 males, mean aged 51.9 years, range 18 to 75 years, the limbs were 222 rights and 138 lefts), CEAP classification was C2,s. Operative technique was standardised to SFJ ligation with the SHL, the GSV was stripped to the level of the knee, multiple phlebectomies were performed and the ligation of the incontinent perforating veins was performed if it was necessary. All patients had a venous reflux from terminal valve of SFJ and the femoral valves were continent. All patients were submitted to clinical examination of the lower limbs and Duplex Scanning (DS) in the pre/postoperative period every year after surgery and by two independent operator in 2013. The follow-up is from 5 years for the patients operated in 2008 to 12 years for the patients operated in 2001.
  
  
  RESULTS
  The neovascularizations and recurrencies in the groin were founded in 7 patients, the incidence is 1.9% of the total cases. The GSV stump and the left tributaries were open to venous flow, it was no venous reflux from the groin, no venous thrombosis of the GSV stump were detected.
  
  
  CONCLUSIONS
  The SHL of the SFJ is a reliable technique, decreasing the incidence of neovascularizations and recurrent varicose veins in the operated groin.
authors.affiliation: Valdisieve Hospital, Department of Vascular Surgery, Pontassieve, Florence, Italy - brtma@tin.it.
authors.forename: F
authors.initials: F
authors.lastname: Mariani
authors.forename: S
authors.initials: S
authors.lastname: Mancini
authors.forename: M
authors.initials: M
authors.lastname: Bucalossi
authors.forename: C
authors.initials: C
authors.lastname: Allegra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006119:Groin / Q000098:blood supply*; D006801:Humans; D007558:Italy; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D012008:Recurrence; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*; D055815:Young Adult