A Novel Endoscopic Approach to Fibroadipose Vascular Anomaly.

Background: Open surgery is the standard treatment for fibroadipose vascular anomalies (FAVA). This study evaluated an endoscopic approach for FAVA, assessing its safety and feasibility.

Methods: Data from October 1, 2019, and May 1, 2024, were analyzed from the Vascular Anomalies Center database at our institution. Patients with FAVA Stage I (pain stage) or II (contracture stage) were included and divided into the endoscopic surgery group (ESG) and open surgery group (OSG).

Results: In total, 101 patients underwent 110 procedures. In ESG, 42 patients (16 males and 26 females; 31 with Stage I and 11 with Stage II) underwent radical excision (with tendon lengthening in 2 patients). Ten patients underwent an open surgery. In OSG, 63 patients (18 males and 45 females; 30 with Stage I and 33 with Stage II) underwent radical excision (with tendon lengthening in 12 patients). The OSG had significantly shorter operative time than the ESG (p = 0.009). Furthermore, The OSG had longer hospitalization time (p = 0.022) than the ESG. The blood loss in the OSG was greater than that in the ESG, but without statistical difference (p = 0.069). During follow-up, the incidence of wound complications (p = 0.121) and residual symptoms (p = 0.179) were slightly higher in the OSG.

Conclusions: Endoscopic surgery is a safe and effective treatment for FAVA, promoting faster habilitation and improved patient satisfaction. This method may also serve as a reference for the excision of other benign muscle and soft tissue masses.