[The future of systematic resections of the external saphenous vein]

Basing his argument on a study of 58 tibial varicose recurrences, the author shows the long-term unreliability of systematic resections of the sapheno-femoral junctions of short saphenous veins not directly pathological. The reasons for this unreliability are to be found in the large number of anatomical variants, especially those concerning emptying into the popliteal vein, which is often sited several centimetres away from the interline of the knee, and the possibility of a double sapheno-femoral junction. Moreover, the existence of large, incompetent long, or less frequently short, sural veins has been found in two-thirds of the cases, contributing to the recurrence or constituting the determining factor. The author draws from this fact the conclusion that surgical indications are restricted. Surgery should be carried out on short saphenous veins which are clearly dilated and incompetent; the emptying level of the sapheno-femoral junction should be ascertained, as should duplicity or major sural incompetence, so that an operation may be carried out which is as complete as possible.