Hitoshi Kusagawa1, Naoki Haruta2, Ryo Shinhara3, Yuji Hoshino4, Atsushi Tabuchi5, Hiromitsu Sugawara6, Koji Shinozaki7, Kenji Matsuzaki8, Hidetoshi Nagata9, Hiroyuki Niihara10, Kunie Kohno11, Ryoji Takeda12. 1. 1 Department of Thoracic and Cardiovascular Surgery, Matsusaka Chuo General Hospital, Matsusaka, Japan (Presently, Matsusaka Ohta Clinic, Matsusaka, Japan). 2. 2 Department of Vascular Surgery, Takanobashi Central Hospital, Hiroshima, Japan. 3. 3 Department of Vascular Surgery, Mitsubishi Mihara Hospital, Mihara, Japan. 4. 4 Department of Vascular Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan. 5. 5 Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan. 6. 6 Department of Surgery, Sendai Hospital of East Japan Railway Company, Sendai, Japan. 7. 7 Department of Surgery, Kobe Ekisai-kai Hospital, Kobe, Japan. 8. 8 Department of Cardiovascular Surgery, NTT Sapporo Hospital, Sapporo, Japan. 9. 9 Department of Surgery, Fujita Health University Banbuntane-hotokukai Hospital, Nagoya, Japan. 10. 10 Department of Dermatology, Shimane University Faculty of Medicine, Izumo, Japan. 11. 11 Center for Community-Based Health Research and Education (COHRE), Organization for the Promotion of Project Research, Shimane University, Izumo, Japan. 12. 12 Department of Vascular Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan.
Abstract
OBJECTIVES: To clarify the surgical methods and the clinical results of subfascial endoscopic perforator surgery in Japan. METHODS: This study included 1287 limbs of 1091 patients who underwent subfascial endoscopic perforator surgery in 14 hospitals. Simultaneous saphenous vein treatment was performed in 1079 limbs (83.8%), and 118 limbs (9.2%) had deep venous lesions. The venous clinical severity score was calculated before and 6 to 12 months after surgery. The ulcer healing rate and ulcer recurrence rate were calculated cumulatively. RESULTS: Preoperative venous clinical severity score was significantly decreased from 10.0 ± 6.6 to 3.1 ± 3.4 ( P < .0001) postoperatively. The primary ulcer healing rate was 96.2% (332/345 C6 limbs) at an average follow-up of 47.7 months, and the ulcer recurrence rate was 12.0% (49/393 C5, C6 limbs) at the average follow-up of 46.0 months after the ulcer healed. CONCLUSION: These results indicate that subfascial endoscopic perforator surgery is an alternative to improve the long-lasting disease severity and/or clinical outcome.
OBJECTIVES: To clarify the surgical methods and the clinical results of subfascial endoscopic perforator surgery in Japan. METHODS: This study included 1287 limbs of 1091 patients who underwent subfascial endoscopic perforator surgery in 14 hospitals. Simultaneous saphenous vein treatment was performed in 1079 limbs (83.8%), and 118 limbs (9.2%) had deep venous lesions. The venous clinical severity score was calculated before and 6 to 12 months after surgery. The ulcer healing rate and ulcer recurrence rate were calculated cumulatively. RESULTS: Preoperative venous clinical severity score was significantly decreased from 10.0 ± 6.6 to 3.1 ± 3.4 ( P < .0001) postoperatively. The primary ulcer healing rate was 96.2% (332/345 C6 limbs) at an average follow-up of 47.7 months, and the ulcer recurrence rate was 12.0% (49/393 C5, C6 limbs) at the average follow-up of 46.0 months after the ulcer healed. CONCLUSION: These results indicate that subfascial endoscopic perforator surgery is an alternative to improve the long-lasting disease severity and/or clinical outcome.