Control study of subfascial endoscopic perforator surgery combined with foam sclerotherapy and saphenous vein stripping surgery in the treatment of leg ulcers

Abstract

Objective With non varicose saphenous vein retention, to evaluate the clinical efficacy of subfascial endoscopic perforating vein disconnection combined with foam sclerotherapy for venous leg ulcer. Methods Prospective analysis of 76 limbs with venous ulcer of lower extremities (from January 2013 to December 2013) in 65 patients was carried out. All the cases were randomly divided into two groups by Excel table. Group A is endoscopic technique combined with foam sclerotherapy, 33 cases (39 limbs), undergoing subfascial endoscopic perforating vein disconnection combined with foam sclerotherapy. Group B is the traditional stripping of great saphenous vein, 32 cases (37 limbs), undergoing the traditional high ligation of great saphenous vein and varicose vein trunk, branches of stripping. Using CEAP score and the clinical severity score (VCSS), the changes of the two groups pre-and postoperative were compared. Results There was no significant difference in CEAP classification and VCSS score between the two groups before operation (P>0.05). The VCSS values of groups A were 13.8±0.6 and 4.8±0.9 before and after operation. There was significant difference between group A before and after operation(P<0.05). The VCSS values of groups A were 13.7±0.5 and 8.0±1.8 before and after operation. There was significant difference between group B before and after operation(P<0.05). The difference of VCSS between the two groups before and after operation were (9.0±0.9), (5.7±1.3). The difference between the two groups was statistically significant. Conclusions Endoscopic perforator disconnection combined with foam sclerotherapy for venous ulcer of lower extremities, can effectively block the ulcer area congestion venous hypertension.The curative effect is better than that of the saphenous vein stripping. There is no close relationship between occurrence of lower extremity venous ulceration and varicose vein. Key words: Varicose ulcer; Communicating vein; Endoscopy; Foam sclerotherapy