title: Subfascial endoscopic perforator surgery (SEPS) in chronic venous insufficiency. A 14 years experience.
abstract: BACKGROUND
  Subfascial Endoscopic Perforator Surgery (SEPS) enables the direct visualization and section of perforating veins. Morbidity and duration of hospitalization are both less than with conventional open surgery (Linton's or Felder's techniques).
  
  
  METHODS
  A total of 322 legs from 285 patients with a mean age of 56 years (range 23-90) were treated at our Department from May 1996 to January 2010. In 309 cases, an endoscope (ETM Endoskopische Technik GmbH, Berlin, Germany) was introduced through a transverse incision approximately 1.5 cm in length and 10 cm from the tibial tuberosity, as with Linton's technique. A spacemaker balloon dissector for SEPS, involving a second incision 6 cm from the first, was used in only 13 cases.
  
  
  RESULTS
  The procedure used in each case was decided on the basis of preoperative evaluation. SEPS and stripping were performed in 238 limbs (73.91%), SEPS and short stripping in 7 limbs (2.17%), SEPS and crossectomy in 51 limbs (15.84%), and SEPS alone in 26 limbs (8.07%). 103 patients presented a total of 158 trophic ulcers; the healing time was between 1 and 3 months, with a healing rate of 82.91% after 1 month and 98.73% after 3 months.
  
  
  CONCLUSIONS
  Subfascial ligature of perforating veins is superior to sclerotherapy and minimally invasive suprafascial treatment for the treatment of CVI. It is easy to execute, minimally invasive and has few complications.
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Battista
authors.forename: V
authors.initials: V
authors.lastname: D'Andrea
authors.forename: A
authors.initials: A
authors.lastname: Galani
authors.forename: F
authors.initials: F
authors.lastname: De Cristofaro
authors.forename: S
authors.initials: S
authors.lastname: Guarino
authors.forename: A
authors.initials: A
authors.lastname: Pulcini
authors.forename: M
authors.initials: M
authors.lastname: Nardi
authors.forename: A
authors.initials: A
authors.lastname: Maturo
authors.forename: S
authors.initials: S
authors.lastname: Palermo
authors.forename: E
authors.initials: E
authors.lastname: De Antoni
authors.forename: F
authors.initials: F
authors.lastname: Stio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017546:Angioscopy / Q000295:instrumentation / Q000379:methods; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000601:surgery*; D014945:Wound Healing