Primary surgery for sapheno-femoral incompetence: A randomised controlled trial to compare two techniques to reduce lymphatic complications.

ABSTRACT

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. PATIENTS AND 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.