title: Early clinical outcomes after subfascial endoscopic perforator surgery (SEPS) and saphenous vein surgery in chronic venous insufficiency.
abstract: BACKGROUND
  Subfascial endoscopic perforator surgery (SEPS) has recently become popular as a minimally invasive way to treat chronic venous insufficiency (CVI) of the lower extremities. We report the early clinical outcomes of SEPS and saphenous vein surgery in a prospective series of Chinese patients who presented with severe CVI.
  
  
  METHODS
  All patients referred to our hospital for the management of severe CVI (class IV disease or above) after January 1998 underwent SEPS using an ultrasonic scalpel in conjunction with saphenous vein surgery. All patients were followed up prospectively to assess ulcer healing, ulcer recurrence, and symptoms after SEPS. Clinical outcome was evaluated by the scoring system suggested by the Consensus Committee of the American Venous Forum on Chronic Venous Disease.
  
  
  RESULTS
  Over a 24-month period, we performed 36 SEPS on 31 patients. Nineteen lower extremities (53%) had active or healing ulcers. Sapheno-femoral ligation was also performed in 33 limbs (92%). Four limbs (11%) developed superficial wound infection, and two (6%) had saphenous nerve dysesthesia. The mean clinical score and disability score decreased from 8.42 to 3.42 and 1.45 to 0.31 respectively, after a median follow-up of 14 months (range, 6-22) (p < 0.005). Eleven ulcers (58%) healed within 6 weeks after surgery. At 1-year follow-up, ulcer recurrence was found in two legs (11%).
  
  
  CONCLUSIONS
  SEPS is safe and feasible. Early clinical results have shown a promising outcome in patients with severe chronic venous insufficiency.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China.
authors.forename: D W
authors.initials: DW
authors.lastname: Lee
authors.forename: A C
authors.initials: AC
authors.lastname: Chan
authors.forename: Y H
authors.initials: YH
authors.lastname: Lam
authors.forename: S K
authors.initials: SK
authors.lastname: Wong
authors.forename: T M
authors.initials: TM
authors.lastname: Fung
authors.forename: L M
authors.initials: LM
authors.lastname: Mui
authors.forename: E K
authors.initials: EK
authors.lastname: Ng
authors.forename: S C
authors.initials: SC
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000175:diagnosis / Q000601:surgery; D014689:Venous Insufficiency / Q000175:diagnosis / Q000601:surgery*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000601:surgery; D014945:Wound Healing