腔镜筋膜下交通静脉离断术治疗下肢慢性静脉功能不全

Subfascial Endoscopic Perforator Surgery (SEPS) for Treatment of Chronic Venous Insufficiency of Lower Extremities

目的：探讨腔镜筋膜下交通支静脉离断术在治疗下肢慢性静脉功能不全中的作用。方法：选取CEAP分级C4级以上的患者22例（共27条肢体）行腔镜深筋膜下交通静脉离断术,并联合施行大隐静脉及曲张浅静脉剥脱术。结果：22例术后症状和浅静脉曲张消失,无切口感染坏死、皮下气肿及筋膜腔血肿等并发症。足靴区色素沉着及硬化明显改善,6例足靴区活动性溃疡在术后2周内愈合。随访1~12个月无静脉曲张及溃疡复发。结论：腔镜深筋膜下交通静脉离断术具有交通支静脉离断彻底、损伤小、恢复快、复发率低、并发症少等优点,可作为治疗CEAP分级Ap、PR的CVI患者的重要手段。

Objective To evaluate the efficacy of Subfascial Endoscopic Perforator Surgery （SEPS） in treating chronic venous insufficiency （CVI） of lower extremities. Methods Twenty-two patients （27 suffered limbs） with CVI （CEAP≥C4） underwent SEPS. Saphenous Stripping and avulsion of varicosities were performed at the same time. Results The surgery obviously ameliorated venous disability, varicose veins, local pigmentation and induration. Ulcers in 6 cases healed within 2 weeks after surgery. All the cases had no surgical complications and recurrence after 1 to 12 months of following up. Conclusion SEPS is a safe and effective technique with advantages of thorough ablation of perforator veins, less injury, with lower complication and recurrence rates, hence is of value in clinical treatment of CVI （Ap, PR）