title: Endoscopic subfascial discission of perforating veins.
abstract: The insufficiency of perforating veins is thought to be crucial in the pathogenesis of varicose and postphlebitic ulcers as well as postoperative varicose vein recurrence. Their eradication is a valid and effective therapeutic concept. No presently available technique has yielded satisfactory results, hence our efforts to develop a new method: the endoscopic subfascial discission of perforating veins (ESDP). It involves performing a small incision in an area remote from the point of trophic disturbance and allows the operator to accurately and atraumatically perform a subfascial discission of the perforating veins where they join the deep veins under direct endoscopic control. Our initial experience with the technique showed promising results: 78%-93% good and very good results depending on the clinical parameters applied. These are the results of a follow-up period of up to 14 months. During that time, none of our patients developed a complication or recurrence. Our technique has many advantages over traditional techniques of perforator vein eradication: (1) more accurate localization; (2) improved wound healing, (3) dependable occlusion; (4) immediate postoperative mobilization of the patient. We feel that ESDP represents a major advance in the development of better methods of subfascial perforator vein eradication. Greater experience and a longer follow-up period will, however, be required to confirm this initial observation.
authors.affiliation: II. Chirurgischer Lehrstuhl, Universität zu Köln, Städtisches Krankenhaus Köln-Merheim, Federal Republic of Germany.
authors.forename: G
authors.initials: G
authors.lastname: Hauer
authors.forename: J
authors.initials: J
authors.lastname: Barkun
authors.forename: I
authors.initials: I
authors.lastname: Wisser
authors.forename: S
authors.initials: S
authors.lastname: Deiler
mesh_terms: D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011186:Postphlebitic Syndrome / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D014647:Varicose Ulcer / Q000601:surgery*; D014648:Varicose Veins / Q000601:surgery*