OBJECTIVETo investigate the surgical technique of skeletonization of the great saphenous vein (GSV) at the saphenofemoral junction (SFJ) in surgical intervention of primary varicosity and evaluate the outcomes one year after the operation.

METHODSA total of 624 cases (774 limbs) of primary varicosity of the GSV were prospectively divided into skeletonization group (265 cases, 325 limbs) and control group (359 cases, 449 limbs). In the skeletonization group, skeletonization of the GSV at the SFJ, its branches and other aberrantly joined superficial veins was performed, and in the control group, routine high ligation of the GSV was performed, after which laser-ablation of the GSV, GSV stripping, Muller's operation, mutilation of the perforators and ulcer-related operations were performed in both groups.

RESULTSTwenty cases in the skeletonization group were found to have superficial veins directly joining into the femoral vein or into the GSV in different tissue layers. In 14 cases in the control group, the superficial veins of the internal femoris or lateral femoris were mistaken for the GSV. No difference was found in the operating time between the two groups (t=0.68, P>0.05), but the skeletonization group had a significantly less bleeding volume (t=1.75, P<0.05). Statistical differences were found between the two groups in intraoperative bleeding rate in the inguinal regions, venous clinical severity scores (2.1∓0.5 vs 4.6∓0.9, t=1.96, P<0.05), and residual varicosity and recurrences (3/325 vs 13/449, V=1.25, P<0.05) at the one year follow-up.

CONCLUSIONSkeletonization of the GSV and its branches and other aberrantly joined superficial veins at the SFJ can decrease the postoperative residual varicosity and recurrence due to blood reflux.