Short-Term Efficacy of Inguinal Reoperation for Recurrent Saphenofemoral Incompetence using the Stump Suture Technique

Therapie des inguinalen Crossenrezidivs: Ist die offene Re-Crossektomie noch zeitgemäß?

“…The advantages and disadvantages of the method are summarised in ▶ Table 1. However, it is interesting to note that this last aspect does not have a negative effect on patient satisfaction with treatment [14,15,36]. Despite lower complication rates after EVLA than with open surgery in the treatment of recurrent saphenofemoral incompetence, there was no difference in the postoperative patient satisfaction in the previously mentioned study [34].…”

“…1a). It is possible to achieve long-term freedom from saphenofemoral recurrence in this way and, from our own experience in this situation, the operation is not particularly difficult or beset with complications [15]. Various access routes to the origin of the saphenofemoral recurrence have been described, with an anterior approach for less scarred situations and a lateral approach with dissection around the femoral vessels for cases with more severe cicatrisation having proved their worth (▶Fig.…”

“…In the past 20 years, anatomical and prosthetic barrier techniques in particular have been developed and integrated into the surgical procedure in order to reduce the risk of neovascularisation. These techniques include endothelial inversion sutures of the saphenous stump, sutured closure of the fascia cribrosa, and attaching a silicone or polytetrafluoroethylene (PTFE) patch [13,15].…”

“…Various access routes to the origin of the saphenofemoral recurrence have been described, with an anterior approach for less scarred situations and a lateral approach with dissection around the femoral vessels for cases with more severe cicatrisation having proved their worth (▶Fig. 4) [15,35]. Throughout the international literature, however, redo groin surgery is considered to be a challenge for the surgeon, associated with an increased risk of complications, and correspondingly restricting the patient's postoperative activity and quality of life [8,16,18].…”

“…Although open surgical revision in the groin is considered to be the reference method, especially where there is a GSV stump and clinically relevant recurrent varicose veins, it is technically demanding and has a higher risk of complications than primary high ligation [4]. The additional use of barrier techniques in recent years is a very promising development to prevent repeat recurrent saphenofemoral incompetence [13,14,15]. Given the complication risk, less invasive methods such as ultrasound-guided foam sclerotherapy (UGFS) are increasingly being recommended and implemented [6,16].…”