Classic versus Endoscopic Perforating Vein Surgery : a Retrospective Study

Abstract

Purpose and Methods. In this retrospective non-randomized study the results of the Felder technique (n=29) were compared to two endoscopic techniques for ligation of incompetent perforating veins: using a mediastinoscope (n=19) and laparoscopic instruments (n=57). The indication was a venous ulcer in nine, five and thirteen patients respectively, lipodermatosclerosis in thirteen, five and twenty-four, and simple varicose veins in the remaining patients (NS).

Results. The mean number of interrupted perforating veins was 4.2, 2.4 and 3.8 (p < 0.05). I he mean hospital stay was 3.5, 1.9 and 1.6 days (p < 0.0001). The mean period of convalescence was 8.7, 4.1 and 3.7 weeks (NS). The number of complications was 9 (suralis lesion 4, pain/swelling 4, wound problem 1), 6 (saphenous lesion 3, pain/swelling 3) and 15 (pain/swelling 14, deep venous thrombosis 1) (NS).

Ten patients were lost to follow-up (five, two and three). Respectively 19, 12 and 45 patients were satisfied with the end-result. The condition had worsened in one, two and three patients (NS). During the short follow-up period all ulcers healed and there was no recurrence.

Conclusion. The endoscopic techniques produce results comparable to the FELDER procedure, with smaller scars and a tendency towards a faster recovery.

Key Words:

• Venous surgery
• varicose veins
• venous ulcer
• perforating veins
• endoscopic surgery