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Updated: Feb 16, 2026

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Surgical methods and clinical results of subfascial endoscopic perforator surgery in Japan
Hitoshi Kusagawa1, Naoki Haruta2, Ryo Shinhara3
11 Department of Thoracic and Cardiovascular Surgery, Matsusaka Chuo General Hospital, Matsusaka, Japan (Presently, Matsusaka Ohta Clinic, Matsusaka, Japan).
Objectives:
To clarify the surgical methods and the clinical results of subfascial endoscopic perforator surgery in Japan.
Methods:
This study included 1287 limbs of 1091 patients who underwent subfascial endoscopic perforator surgery in 14 hospitals. Simultaneous saphenous vein treatment was performed in 1079 limbs (83.8%), and 118 limbs (9.2%) had deep venous lesions. The venous clinical severity score was calculated before and 6 to 12 months after surgery. The ulcer healing rate and ulcer recurrence rate were calculated cumulatively.
Results:
Preoperative venous clinical severity score was significantly decreased from 10.0 ± 6.6 to 3.1 ± 3.4 ( P < .0001) postoperatively. The primary ulcer healing rate was 96.2% (332/345 C6 limbs) at an average follow-up of 47.7 months, and the ulcer recurrence rate was 12.0% (49/393 C5, C6 limbs) at the average follow-up of 46.0 months after the ulcer healed.
Conclusion:
These results indicate that subfascial endoscopic perforator surgery is an alternative to improve the long-lasting disease severity and/or clinical outcome.
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