Amudhan, M (2020) A Comparative Study of Subfascial Endoscopic Perforator Surgery [SEPS] Versus Open Perforator Ligation [OSPL] in the Treatment of Great Saphenous Varicose Veins. Masters thesis, ESIC Medical College & PGIMS & R, Chennai.
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Abstract
INTROODUCTION: Varicose veins are defined as dilated and tortuous subcutaneous veins, larger than 4mm in the upright position. Severity of the disease may vary from telangiectatic veins to venous ulceration. Subfascial endoscopic perforator surgery (SEPS) is a new minimally invasive technique performed in patients with advanced chronic venous insufficiency, enables surgeons to address perforator vein incompetence less invasively, with small upper calf incisions remote from severely diseased skin in the distal leg, with less surgical complications compared to open subfascial perforator ligation. AIM OF THE STUDY: The aim of the study is to compare the outcomes and complications of open subfascial perforator ligation versus endoscopic perforator surgery (SEPS) for treatment of varicose veins in terms of intra operative time, number of perforators clipped/ligated. Post op pain, day of discharge, day of return to work ,scar size. Present study concludes that SEPS is feasible and cost effective technique. METHODOLOGY: After consulting with the statistician the sample size was set as 50 patients in the study as per the following calculation. SAMPLE SIZE: The required sample size is 12 patients per group by using formula. But after consideration the lost to follow up and to power the study, sample size will be 25 patients per group to test the mean difference between two groups for pain reduction (VAS score). The nMaster (2.0) software was used to calculate the sample size. INCLUSION CRITERIA: All consenting patients presenting with Great saphenous varicose veins and perforator incompetence. Age group between 18 and 65 years. EXCLUSION CRITERIA: Pregnancy, Morbid obesity, Uncontrolled medical conditions, History of previous varicose vein surgeries over the same leg, Patient unfit for anaesthesia. CONCLUSION: It is comparable with OSPL in terms of pre operative diagnosis, intra operative time ,number of perforators clipped/ligated, post operative pain, day of discharge, day of return to work, scar size and post op missed perforators. The operative time in SEPS technique is significantly low as compared to OSPL. The number of perforators clipped in SEPS is significantly higher as compared to number of perforators ligated in OSPL .Post operative pain at day 1, day 3, day 7 is significantly lower in SEPS as compared to OSPL Day of return to work and number of missed perforators assessed post operatively by Doppler study show that there is no significant difference .SEPS has cosmetic benefits over OSPL, both statistically and clinically
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711601 |
| Uncontrolled Keywords: | Subfascial Endoscopic Perforator Surgery (SEPS), Open Perforator Ligation (OSPL), Perforators, RFA. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 18:05 |
| Last Modified: | 12 Feb 2021 18:05 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14083 |
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