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Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: long-term follow-up.
J Vasc Surg. 2001 May; 33(5):1028-32.JV

Abstract

PURPOSE

Subfascial division of incompetent perforating veins seems to be a successful treatment for patients with venous leg ulceration (CEAP 6). For postoperative wound complications, endoscopic techniques are more common than open subfascial division of incompetent perforating veins (Linton procedure). We investigated the long-term results of ulcer healing and recurrence rates and compared them with preoperative and postoperative duplex findings.

METHODS

Patients with venous ulceration on the medial side of the lower leg were randomly allocated to endoscopic exploration or open exploration by means of the modified Linton approach. Ulcer healing and recurrence rates were documented.

RESULTS

Thirty-nine patients were randomly allocated to exploration, 19 patients to open subfascial division of incompetent perforating veins (Linton group), and 20 patients to subfascial endoscopic division of incompetent perforating veins (SEPS group). During the follow-up period, four patients in the SEPS group died, all of causes other than the venous leg ulcer. Because of a squamous cell carcinoma that had developed in the venous ulcer, one patient in the SEPS group underwent a below-knee amputation. In a mean follow-up period of 50.6 months, the venous ulceration of all 18 patients in the Linton group who were available for follow-up initially healed. The recurrence rate in this group was 22% (4 patients). In the SEPS group, the mean follow-up period for 19 patients was 46.1 months, with the ulceration healing in 17 patients and a recurrence rate of 12% (2 patients). The presence of deep venous incompetence (DVI) did not influence the recurrence rates (P =.044, Fisher exact test), but it significantly influenced the development of new incompetent perforating veins (3 of 10 without DVI; 7 of 10 with DVI; P =.011, binomial test).

CONCLUSION

The long-term follow-up results of the endoscopic division of perforating veins are comparable with those of the open division of perforating veins (modified Linton procedure).

Authors+Show Affiliations

Department of Vascular Surgery, Sint Franciscus Hospital, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11331845

Citation

Sybrandy, J E., et al. "Endoscopic Versus Open Subfascial Division of Incompetent Perforating Veins in the Treatment of Venous Leg Ulceration: Long-term Follow-up." Journal of Vascular Surgery, vol. 33, no. 5, 2001, pp. 1028-32.
Sybrandy JE, van Gent WB, Pierik EG, et al. Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: long-term follow-up. J Vasc Surg. 2001;33(5):1028-32.
Sybrandy, J. E., van Gent, W. B., Pierik, E. G., & Wittens, C. H. (2001). Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: long-term follow-up. Journal of Vascular Surgery, 33(5), 1028-32.
Sybrandy JE, et al. Endoscopic Versus Open Subfascial Division of Incompetent Perforating Veins in the Treatment of Venous Leg Ulceration: Long-term Follow-up. J Vasc Surg. 2001;33(5):1028-32. PubMed PMID: 11331845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: long-term follow-up. AU - Sybrandy,J E, AU - van Gent,W B, AU - Pierik,E G, AU - Wittens,C H, PY - 2001/5/2/pubmed PY - 2001/6/8/medline PY - 2001/5/2/entrez SP - 1028 EP - 32 JF - Journal of vascular surgery JO - J Vasc Surg VL - 33 IS - 5 N2 - PURPOSE: Subfascial division of incompetent perforating veins seems to be a successful treatment for patients with venous leg ulceration (CEAP 6). For postoperative wound complications, endoscopic techniques are more common than open subfascial division of incompetent perforating veins (Linton procedure). We investigated the long-term results of ulcer healing and recurrence rates and compared them with preoperative and postoperative duplex findings. METHODS: Patients with venous ulceration on the medial side of the lower leg were randomly allocated to endoscopic exploration or open exploration by means of the modified Linton approach. Ulcer healing and recurrence rates were documented. RESULTS: Thirty-nine patients were randomly allocated to exploration, 19 patients to open subfascial division of incompetent perforating veins (Linton group), and 20 patients to subfascial endoscopic division of incompetent perforating veins (SEPS group). During the follow-up period, four patients in the SEPS group died, all of causes other than the venous leg ulcer. Because of a squamous cell carcinoma that had developed in the venous ulcer, one patient in the SEPS group underwent a below-knee amputation. In a mean follow-up period of 50.6 months, the venous ulceration of all 18 patients in the Linton group who were available for follow-up initially healed. The recurrence rate in this group was 22% (4 patients). In the SEPS group, the mean follow-up period for 19 patients was 46.1 months, with the ulceration healing in 17 patients and a recurrence rate of 12% (2 patients). The presence of deep venous incompetence (DVI) did not influence the recurrence rates (P =.044, Fisher exact test), but it significantly influenced the development of new incompetent perforating veins (3 of 10 without DVI; 7 of 10 with DVI; P =.011, binomial test). CONCLUSION: The long-term follow-up results of the endoscopic division of perforating veins are comparable with those of the open division of perforating veins (modified Linton procedure). SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/11331845/Endoscopic_versus_open_subfascial_division_of_incompetent_perforating_veins_in_the_treatment_of_venous_leg_ulceration:_long_term_follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(01)81162-9 DB - PRIME DP - Unbound Medicine ER -