COMPARATIVE ANALYSIS OF SUBFASCIAL ENDOSCOPIC PERFORATOR SURGERY (SEPS) AND OPEN LIGATION FOR TREATING LOWER LIMB VARICOSITIES

This study compares Subfascial Endoscopic Perforator Surgery (SEPS), a minimally invasive technique, with traditional Open Ligation for treating lower limb varicosities, a manifestation of chronic venous insufficiency (CVI) that affects quality of life through complications like ulcers, edema, and skin pigmentation. Conducted over one year at Kamineni Institute of Medical Sciences, Telangana, the study involved 50 patients divided equally between the two groups, assessing postoperative complications, hospital stay duration, symptom resolution, and varicosity recurrence. Results revealed that SEPS had significant advantages. It demonstrated superior symptom resolution, with 24% of patients achieving complete ulcer healing compared to none in the Open group. Additionally, 60% of SEPS patients experienced complete edema resolution, compared to only 20% in the Open group. SEPS also enabled faster recovery, with 88% of patients discharged within 10 days, whereas all Open group patients required stays of 11 days or longer. The complication rate was lower in SEPS (4%) compared to Open Ligation (8%), with no cases of deep vein thrombosis (DVT) or skin necrosis observed in either group. These findings align with global research, highlighting SEPS as a preferred treatment modality due to its minimally invasive nature, shorter hospital stays, and better clinical outcomes. The study underscores the need for further research, particularly in diverse populations and with long-term follow-up, to validate these findings and assess the cost-effectiveness of SEPS. Comparative studies with emerging minimally invasive techniques such as laser or radiofrequency ablation are also recommended to refine treatment protocols and enhance patient-centric care. SEPS holds promise as a standard of care for chronic venous insufficiency, offering improved recovery and reduced morbidity.