[Subfascial endoscopic perforating-vein surgery. Personal experience].

BACKGROUND

The aim of this paper was to report our personal experience in the endoscopic treatment of chronic venous insufficiency associated with incompetent perforating veins.

METHODS

In the region of 400 cases of chronic venous insufficiency, classified using the new CEAP criteria, were treated over the course of one year at the General Surgery unit of Ospedale SS. Trinità in Fossano (Cuneo). Of these, 47 patients, classified between C2 and C6, underwent endoscopic treatment of insufficient perforating veins showing persistent or recidivating trophic ulcerative lesions; radical internal saphenectomy was associated in 30 cases.

RESULTS

The results were reappraised at 12, 10, 8, 6, 4, 2 and 1 month, and trophic lesions had already healed after 5 weeks in 35 patients. There was a marked clinical improvement and a noticeable change in quality of life in 10 patients, whereas treatment failed in 2 cases. No cases of recidivation have been reported in the patients who were successfully treated, but in spite of an improvement in cutaneous skin trophism, there were persistent dyschromic lesions in 40 patients who underwent SEPS.

CONCLUSIONS

Having compared our experience with that of other authors, we conclude that SEPS is undoubtedly an effective method for the surgical treatment of chronic venous insufficiency with incompetent perforating veins. However, it is harder to establish the real role played by SEPS when treatment is associated with saphenectomy. In view of this, we regard SEPS as a "complementary" treatment forming part of a wider therapeutic context.