ABSTRACT
Comparative study of the results of videoscopic versus mini-incisional ligation of perforating veins of the legs in the treatment of chronic venous insufficiency as regards to ulcer healing and recurrence rates and compared them with preoperative and postoperative duplex findings. Patients with venous ulceration on the medial side of the lower leg were randomly allocated to endoscopic exploration or mini-incisional ligation of perforators. All patients were put in a follow up schedule for 24 months. Ulcer healing and recurrence rates were documented and the results were compared. Fifty patients were randomly allocated to exploration, 24 patients to subfascial endoscopic division of incompetent perforating veins [Group I] and 26 patients to mini-incisional perforator ligation [Group II]. During the follow-up period, two patients in the SEPS group and four patients in the mini-incisional group were lost from follow up. In a mean follow-up period of 24 months, the venous ulceration of all 44 patients in both groups who were available for follow-up initially healed. The recurrence rate in Group I was 18% [4 patients]. In Group II, the recurrence rate was 22.7% [5 patients]. The follow-up results of the endoscopic division of perforating veins are comparable with those of the mini-incisional ligation of perforating veins. There is insignificant difference in recurrence rate. The mini-incisional technique is simpler with low incidence of postoperative wound complications. The ligation of incompetent perforating veins of the legs has high recurrence rate and should be restricted to patients with persistent ulcerations despite goodúconservative treatment. The comparative results of both research techniques make us to restrict SEPS technique to those legs with severe lipodermatosclerosis at the perforator site