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[Endoscopic subfascial dissection of perforators (ESDP) vs open ligation of perforators]
Objective:
Comparison of two surgical procedures in discontinuation of the venae perforantes.
Method:
The authors evaluated perspectively a group of 78 patients subjected to 82 operations with severing of the venae perforantes on the lower extremities. They defined the indications for both surgical procedures.
Results:
The open procedure (Cockett's segmental operation) was indicated in 10 extremities, ESDP in 72. The endoscopic operation lasted on average 59 minutes, the open one 50 minutes. The hospitalization period in the endoscopic variant was shorter (6.1 days vs. 8.5 days after the open operation). preoperative complications such as haemorrhage from the severed perforator occurred in ESDP. In Cockett's operation there were no preoperative complications, but there were two cases of healing per secundam during the postoperative period. Healing of crural ulcers within 12 weeks was recorded in both types of operations. The open procedure is indicated where there are major nodes on the leg and there are no extensive trophic changes, in particular in patients in stages C3 and C4. ESDP is indicated in patients in advanced stages of CVI, i.e. C5 and C6 according to CEAP.
Conclusions:
Every method has its indications whereby a higher incidence of complications may be foreseen after the open operation as compared with the endoscopic one.