Systematic review and meta-analysis of the anatomic variants of the saphenofemoral junction.


Journal

Journal of vascular surgery. Venous and lymphatic disorders
ISSN: 2213-3348
Titre abrégé: J Vasc Surg Venous Lymphat Disord
Pays: United States
ID NLM: 101607771

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 20 02 2018
accepted: 07 06 2018
pubmed: 19 11 2018
medline: 10 3 2020
entrez: 19 11 2018
Statut: ppublish

Résumé

The aim of this systematic review was to provide comprehensive data on the prevalence of variations of the saphenofemoral junction (SFJ) to prevent misidentification of the SFJ or the incomplete ligation of the tributaries of the great saphenous vein. A systematic review was conducted using the PubMed, Embase, and Cochrane Library databases through September 14, 2017. To be included in the meta-analysis, a study had to report prevalence data on the morphology of the SFJ or the presence of venous tributaries. A total of 16 studies (7433 legs) were included. The majority of studies were performed during varicose vein surgery (74.14%), with fewer studies by means of computed tomography venography and cadaveric dissection. The pooled prevalence estimate (PPE) for a duplication of the SFJ with a bifid junction was 9.6% (P = .001). The PPE for a duplication of the SFJ with two separate junctions was 1.7%. The PPE for ectasia of the SFJ was 2.3% in type 1, 1.2% in type 2, and 1.7% in type 3. The distribution of the PPE for the number of venous SFJ tributaries was approximately normal with a slight right skew; a higher rate was observed in the group with four venous tributaries to the SFJ. This analysis found high heterogeneity in the prevalence of SFJ anatomic variants and the number of venous SFJ tributaries. For this reason, it is highly recommended that a preoperative Doppler ultrasound assessment of the SFJ and great saphenous vein be performed.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this systematic review was to provide comprehensive data on the prevalence of variations of the saphenofemoral junction (SFJ) to prevent misidentification of the SFJ or the incomplete ligation of the tributaries of the great saphenous vein.
METHODS METHODS
A systematic review was conducted using the PubMed, Embase, and Cochrane Library databases through September 14, 2017. To be included in the meta-analysis, a study had to report prevalence data on the morphology of the SFJ or the presence of venous tributaries.
RESULTS RESULTS
A total of 16 studies (7433 legs) were included. The majority of studies were performed during varicose vein surgery (74.14%), with fewer studies by means of computed tomography venography and cadaveric dissection. The pooled prevalence estimate (PPE) for a duplication of the SFJ with a bifid junction was 9.6% (P = .001). The PPE for a duplication of the SFJ with two separate junctions was 1.7%. The PPE for ectasia of the SFJ was 2.3% in type 1, 1.2% in type 2, and 1.7% in type 3. The distribution of the PPE for the number of venous SFJ tributaries was approximately normal with a slight right skew; a higher rate was observed in the group with four venous tributaries to the SFJ.
CONCLUSIONS CONCLUSIONS
This analysis found high heterogeneity in the prevalence of SFJ anatomic variants and the number of venous SFJ tributaries. For this reason, it is highly recommended that a preoperative Doppler ultrasound assessment of the SFJ and great saphenous vein be performed.

Identifiants

pubmed: 30448153
pii: S2213-333X(18)30256-7
doi: 10.1016/j.jvsv.2018.06.006
pii:
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

128-138.e7

Informations de copyright

Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Roberto Cirocchi (R)

Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy.

Brandon Michael Henry (BM)

Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland. Electronic address: bmhenry55@gmail.com.

Massimo Rambotti (M)

Unit of Surgery, Casa di Cura "Villa Pini", Civitanova Marche, Italy.

Krzysztof A Tomaszewski (KA)

Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.

Massimo Cappelli (M)

Private Centro Vena, Florence, Italy.

Gianfranco Vettorello (G)

Department of General Surgery, General Hospital, Tolmezzo, Udine, Italy.

Alessandra Pistilli (A)

Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy.

Vito D'Andrea (V)

Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.

Bruno Amato (B)

Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Justus Randolph (J)

Tift College of Education, Mercer University, Atlanta, Ga.

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Classifications MeSH