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[Subfascial endoscopic perforating-vein surgery. Personal experience]
F Costante1, D Panero, I Lanati
1ASL n. 17, Regione Piemonte, Divisione di Chirurgia Generale, Sede di Fossano (Cuneo), Italy.
Minerva Chirurgica
|November 7, 2003
Summary
Endoscopic treatment of chronic venous insufficiency with incompetent perforating veins showed effective healing of trophic lesions and improved quality of life. Subfascial Endoscopic Perforator Surgery (SEPS) is a valuable complementary treatment for this condition.
Area of Science:
- Vascular Surgery
- Minimally Invasive Procedures
Background:
- Chronic venous insufficiency (CVI) affects a significant patient population.
- Incompetent perforating veins are a key factor in CVI pathogenesis.
- Trophic ulcerative lesions are a common and debilitating manifestation of CVI.
Purpose of the Study:
- To report personal experience with endoscopic treatment of CVI.
- To evaluate the efficacy of Subfascial Endoscopic Perforator Surgery (SEPS) for incompetent perforating veins.
- To assess the impact on trophic lesions and quality of life.
Main Methods:
- Retrospective analysis of 47 patients with CVI (CEAP C2-C6) undergoing SEPS.
- 30 patients also underwent radical internal saphenectomy.
- Follow-up assessments included clinical improvement and lesion healing.
Main Results:
- Trophic lesions healed in 35 patients within 5 weeks.
- Marked clinical improvement and enhanced quality of life observed in 10 patients.
- SEPS demonstrated effectiveness, though its role alongside saphenectomy requires further clarification; 2 treatment failures reported.
Conclusions:
- SEPS is an effective surgical treatment for CVI with incompetent perforating veins.
- SEPS can be considered a complementary therapy within a broader treatment strategy.
- Further research is needed to define SEPS's precise role when combined with saphenectomy.