TITLE

Lateral Subfascial Endoscopic Perforating Vein Surgery as Treatment for Lateral Perforating Vein Incompetence and Venous Ulceration

AUTHOR(S)
Mao-hua Wang; Xing Jin; Shi-yi Zhang; Xue-jun Wu; Zhen-yue Zhong; Mo Wang; Dian-ning Dong; Hai Yuan
PUB. DATE
May 2009
SOURCE
World Journal of Surgery;May2009, Vol. 33 Issue 5, p1093
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The aim of this study was to evaluate the clinical results of lateral subfascial endoscopic perforating vein surgery (SEPS). Our study was conducted from February 2002 to January 2007. Sixty-three patients with lateral incompetent perforating veins (IPVs) and venous ulceration were allocated to two groups. Group 1 comprised 31 patients (33 limbs) who underwent only routine surgery (saphenofemoral or saphenopopliteal ligation, stripping, phlebectomies, endovascular laser treatment [EVLT], medial SEPS, and skin grafting). Group 2 comprised 32 patients (35 limbs) who underwent our routine surgery with the addition of lateral SEPS. Bidirectional ultrasonography was performed before the operation, and 6 weeks, 6 months, and 1 year after surgery. Clinical score and disability score were collected at the same time. Twenty-nine (87.9%) of 33 limbs with active ulcers in group 1 healed, with recurrence in four (12.1%) limbs at follow-up at 25.9 ± 10.0 months. All 35 limbs in group 2 healed, with recurrence in 0 (0.0%) limbs at follow-up at 25.4 ± 10.1 months. Lateral SEPS could reduce the rate of recurrence of ulcers (Kaplan–Meier analysis). Patients in group 2 also showed improvement in clinical and disability scores, although they were not statistically significant differences ( t test, p > 0.05). A significantly higher proportion of patients in group 1 had IPVs on the lateral aspect of the lower leg on ultrosonography imaging. Lateral SEPS could contribute to ulcer healing and reduce ulcer recurrence. The addition of lateral SEPS to routine surgery did reduce the number of IPVs. Lateral SEPS may be safe and effective for lateral perforating vein incompetence and venous ulceration.
ACCESSION #
37827207

 

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