Original article

Subfascial endoscopic perforator surgery combined with endovenous laser ablation in treatment of lower extremity varicose veins

Expand
  • Department of Vascular Surgery, Shanghai General Hospital, Shanghai 201620, China

Received date: 2018-06-20

  Online published: 2020-07-25

Abstract

Objective To evaluate the feasibility of subfascial endoscopic perforator surgery (SEPS) combined with endovenous laser treatment (EVLT) in treatment of lower extremity varicose vein. Methods A total of 81 limbs with valve insufficiency of venous perforators diagnosed by ascending phlebography from August 2016 to October 2017 were selected including 40 limbs received SEPS combining with EVLT and preservation of greater saphenous vein as study group and 41 limbs received classic stripping of greater saphenous vein with high ligation as control group. Results Varicosities and tributaries of patients in 2 groups were all disappeared with skin pigmentation lightened and ulcer healed. The symptoms did not recur during the period of follow-up from 5 to 11 months. The operation time in study group was less than that in control group (1.1 h vs 3.0 h, P<0.01) and the incision number was less in study group than in control group (2.1 vs 5.8, P<0.01). Decrease in hospital stay (1.1 d vs 3.9 d, P<0.01) and ecchymosis area of lower extremities (5.2 cm2 vs 20.3 cm2, P<0.01) in study group was found when compared those in control group. The difference all had statistical significance. Conclusions SEPS combined with EVLT and preservation of greater saphenous vein in treatment of lower extremity varicose vein would be minimal invasive and recover quickly.

Cite this article

PAN Yuqin, LI Yang, MAO Jieqi, LI Ke, GAN Shujie . Subfascial endoscopic perforator surgery combined with endovenous laser ablation in treatment of lower extremity varicose veins[J]. Journal of Surgery Concepts & Practice, 2018 , 23(06) : 539 -541 . DOI: 10.16139/j.1007-9610.2018.06.015

References

[1] Hauer G.Endoscopic subfascial discussion of perforationg veins-preliminary report[J]. Vasa,1985,14(1):59-61.
[2] Zhang J, Xiao M, Kang N, et al.Value of contrast-enhanced ultrasound in detecting competent and incompetent lower-extremity perforating veins[J]. Ultrasound Med Biol,2018,44(8):1721-1726.
[3] Figueiredo M, de Araujo SP, Figueiredo MF. Late follow-up of saphenofemoral junction ligation combined with ultrasound guided foam sclerotherapy in patient with venous ulcers[J]. AnnVacs Surg,2012,26(7):977-981.
[4] Ikponmwosa A, Abbott C, Graham A, et al.The impact of different concentrations of sodium tetradecyl sulphate and initial balloon denudation on endothelial cell loss and tunica media injuy in a model of foam sclerotherapy[J]. Eur J Vasc Endovasc Surg,2010,39(3):366-371.
[5] Stoǐko IM, Talibov OB, Iashkin MN, et al.Multicentre observational study of Phlebodia 600 in treatment of patients with CEAP class C0-C3 chronic venous diseases[J]. Angiol Sosud Khir,2018,24(1):107-114.
[6] Baker SR, Burnand KG, Sommerville KM, et al.Compa-rison of venous reflux assessed by duplex scanning and descending phlebography in chronic venous disease[J]. Lancet,1993,341(8842):400-403.
[7] Kumar CM, van Zundert AAJ. Intraoperative Valsalva maneuver: a narrative review[J]. Can J Anaesth,2018,65(5):578-585.
[8] 姚凯, 聂晚频, 卢玲俐, 等. 内镜筋膜下交通支静脉离断术治疗下肢慢性静脉性溃疡的临床研究[J]. 中南大学学报(医学版),2009,34(8):830-833.
[9] Haruta N.Recent progress of varicose vein treatment especially about endovascular heat ablation, SEPS and foam sclerotherapy[J]. Ann Vasc Dis,2018,11(1):66-71.
[10] Kalinin RE, Suchkov IA, Shanaev IN.Errors in crural perforant veins ligation[J]. Khirurgiia (Mosk),2016,(7):45-48.
[11] 韩道正, 沈超, 周云, 等. 下肢静脉影像学检查在静脉功能不全术前评估中的研究进展[J]. 血管与腔内血管外科杂志,2017,3(2):685-689.
[12] Tabuchi A, Masaki H, Tanemoto K.Subfascial endoscopic perforator vein surgery in the treatment of severe varicose veins[J]. Nihon Geka Gakkai Zasshi,2015,116(3):166-170.
[13] 侯乐伟, 邓国瑜, 梅志军, 等. 筋膜下经内镜穿通静脉离断术治疗下肢静脉性溃疡10年临床随访[J]. 现代生物医学进展,2014,14(20):3896-3897.
Outlines

/