This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Persistent popliteal fossa reflux following saphenopopliteal disconnection. BJS 2002; 89: 748-751.

Published: 5th November 2002

Authors: H. I. Rashid, A. Ajeel, M. R. Tyrrell

Background

This was a retrospective assessment of the technical adequacy of saphenopopliteal disconnection (SPD).

Method

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.

Conclusion

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