الفهرس 
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Abstract
The aim of this work was to study the early clinical outcomes of Subfascial endoscopic perforator vein surgery in treatment of chronic venous insufficiency (CVI) of the lower limbs, 42 patients were entered in this study after taking an informed consent from them. These 42 patients were divided into two groups: group (A)patients were treated by conservative line of treatment including: bed rest, elevation, systemic analgesic & anti-inflammatory drugs, venotonics, antihistaminics, dressings, antibiotics if there was infection , compression by crepe bandages, SFJ &SPJ disconnection if they are incompetent and/or stripping if needed and Subfacial endoscopic perforator vein surgery. Group (B) will be treated by conservative line of treatment only.
Patient of any age & sex diagnosed as chronic venous insufficiency of the lower limbs, Clinical stages 4 to 6. All patients did not have DVT, signs or symptoms of chronic lower limb ischemia, ulcers due to other causes.
Clinical and duplex examinations were done at time of the presentation to assess the SFJ &SPJ competence, perforators & deep system competence and patency also routine laboratory investigations were done.
The mean age (± SD) in group A was 41.95 ± 12.39 year, and in group B was 42.33 ± 13.66 year. The history & risk factors were nearly similar in the two groups as regard hereditary factors, previous surgery, previous DVT, smoking, BMI ,blood pressure, history of DM, stockings, first time ulcer to appear or occupational long standing up.
All patients were complaining of in group A: 9 patients(42.9%) complained of mild pain and 12 patients(57.1%) of severe pain,12 patients(57.1%) complained of mild lower limb oedema and 9 patients(42.9%) of severe oedema, 10 patients(47.6%) complained of mild lower limb claudication and 11 patients(52.4%) of severe claudication,9 patients(42.9%) complained of localized pigmentation and 12 patients(57.1%) of extensive one, 8 patients (38.1%) complained of localized lipodermatosclerosis and 13 patients(61.9%) of extensive one, 12 patients(57.1%) had single ulcer and only one patient(4.8%) had multiple ulcers, 3 patients(14.3%) had ulcer size <2cm and 10 patients(47.6%) had ulcer size >2cm.while in group B: 5 patients(23.8%) complained of mild pain and 15 patients(71.4%) of severe pain, 9 patients(42.9%) complained of mild oedema and 10 patients(47.6%) of severe oedema, 8 patients(38.1%) complained of mild claudication and 13 patients(61.9%) of severe claudication, 11 patients(52.4%) complained of localized pigmentation and 10 patients(47.6%) of extensive one, 9 patients (42.9%) complained of localized lipodermatosclerosis and 12 patients(57.1%) of extensive one, 12 patients(57.1%) had single ulcer and 3 patients(14.3%) had multiple ulcers, 2 patients(9.5%) had ulcer size <2cm and 13 patients(61.9%) had ulcer size >2cm.
Mean number of perforators ligated in group A was 7.47 ± 2.36 perforator, 6 patients(61.9%) had SFD, one patient(4.8%) had SFD&stripping&3patients(14.3%)had SPD.While Group B: 4 patients (19%) had SFD, one patient(4.8%) had SFD&stripping& only one patient (4.8%) had punchectomy, mean number of hospital stay: 1.47 ± 1.33 day in group A &7.52 ± 3.95 day in group B .