Background: Subfascial endoscopic perforator surgery is an important element in the surgical treatment of patients with chronic venous insufficiency complications. In this paper, which is based on the authors’ own material, early and long term results are presented. The limitations of the method and current indications are also discussed.
Material and methods: From 1996 to 2003, 33 patients with chronic venous insufficiency complications were treated. In this group, there were 10 patients with active venous crural ulcers (30%). 8 other patients reported the presence of a venous ulceration in the past (24%). The surgery (SEPS) was performed under spinal anesthesia. In 17 cases SESP was combined with surgical procedures reducing superficial vein system venous hypertension. Early and late results were evaluated.
Results: The healing of ulcers within 3 months after surgery was achieved in 9 out of 10 patients with active crural ulcers. Among the 33 patients who underwent an operation, DVT after surgery was present in one case. In 2 other cases infective complications or improper wound healing was observed. In 2 cases acpostoperative paresthesia was reported. During the follow up, the recurrence of an ulceration was observed in one case — over 6 months after surgery.
Conclusions: 1. In properly qualified patients, SEPS is a successful treatment method also decreasing the rate of the chronic venous insufficiency recurrence. 2. Surgical endoscopic perforator ablation decreases the rate of ulcer recurrence. However, in all cases, if possible, the reduction of superficial vein system hypertension is necessary. 3. Despite the proper surgical treatment, the progress of venous system insufficiency can lead to ulcer recurrence which confirms the necessity of a continuous follow up of this patient group.