2017The Egyptian Journal of SurgeryRequires access

Efficacy of endovenous laser ablation (endovenous laser ablation) versus conventional stripping in the treatment of great saphenous vein reflux

El-SayedA Abd El-Mabood, RefaatS Salama

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Abstract

Purpose The purpose of this study was to find out the advantages and efficacy of endovenous laser ablation (EVLA) versus conventional stripping in the treatment of great saphenous vein (GSV) reflux. Background Varicose vein treatment places a considerable strain on the medical system, with long waiting time for operation in the public hospital system. EVLA allows efficient treatment of many patients on an outpatient basis. Patients and methods This prospective study included 44 patients with primary varicose veins. Patients were randomly allocated into two groups according to the intervention performed − group A: conventional surgical stripping of the GSV [22 (50%)], and group B: EVLA ablation [22 (50%)]. All patients underwent clinical evaluation, routine hematological tests, and venous duplex of both lower limbs. The follow-up period was 6 months. Results There were satisfactory results in the EVLA group (group B); in about 20 (90.8%) cases of this group the procedure was performed under tumescent anesthesia with less mean postoperative time, 69.1±3 min, less postoperative pain rate, 4.05±1.23, less 1-week complications limited to Bruising and Ecchymosis in five (23.8%) cases, superficial phlebitis in three (14.28%) cases, developed thrombosis in two (9.52%) cases, or skin burn in one (4.76%) case. Rapid return to normal activity (5.8±1.5) and overall results were better in group B, 19 (90.47%), compared with group B, 14 (66.66%), with a P-value of 0.001. Conclusion EVLA of GSV, being simple to perform and well accepted by patients, is a safe and effective method with low rate of complications, one-day hospitalization, short recovery time, and quick return to professional activities. For these reasons, this method is considered a very promising technique especially in female patients for cosmetic reasons as compared with surgical stripping.

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What this paper is about

Purpose The purpose of this study was to find out the advantages and efficacy of endovenous laser ablation (EVLA) versus conventional stripping in the treatment of great saphenous vein (GSV) reflux. Background Varicose vein treatment places a considerable strain on the medical system, with long waiting time for operation in the public hospital system. EVLA allows efficient treatment of many patients on an outpatient basis. Patients and methods This prospective study included 44 patients with primary varicose veins. Patients were randomly allocated into two groups according to the intervention performed − group A: conventional surgical stripping of the GSV [22 (50%)], and group B: EVLA ablation [22 (50%)]. All patients underwent clinical evaluation, routine hematological tests, and venous duplex of both lower limbs. The follow-up period was 6 months. Results There were satisfactory results in the EVLA group (group B); in about 20 (90.8%) cases of this group the procedure was performed under tumescent anesthesia with less mean postoperative time, 69.1±3 min, less postoperative pain rate, 4.05±1.23, less 1-week complications limited to Bruising and Ecchymosis in five (23.8%) cases, superficial phlebitis in three (14.28%) cases, developed thrombosis in two (9.52%) cases, or skin burn in one (4.76%) case. Rapid return to normal activity (5.8±1.5) and overall results were better in group B, 19 (90.47%), compared with group B, 14 (66.66%), with a P-value of 0.001. Conclusion EVLA of GSV, being simple to perform and well accepted by patients, is a safe and effective method with low rate of complications, one-day hospitalization, short recovery time, and quick return to professional activities. For these reasons, this method is considered a very promising technique especially in female patients for cosmetic reasons as compared with surgical stripping.

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Available abstract

Purpose The purpose of this study was to find out the advantages and efficacy of endovenous laser ablation (EVLA) versus conventional stripping in the treatment of great saphenous vein (GSV) reflux. Background Varicose vein treatment places a considerable strain on the medical system, with long waiting time for operation in the public hospital system. EVLA allows efficient treatment of many patients on an outpatient basis. Patients and methods This prospective study included 44 patients with primary varicose veins. Patients were randomly allocated into two groups according to the intervention performed − group A: conventional surgical stripping of the GSV [22 (50%)], and group B: EVLA ablation [22 (50%)]. All patients underwent clinical evaluation, routine hematological tests, and venous duplex of both lower limbs. The follow-up period was 6 months. Results There were satisfactory results in the EVLA group (group B); in about 20 (90.8%) cases of this group the procedure was performed under tumescent anesthesia with less mean postoperative time, 69.1±3 min, less postoperative pain rate, 4.05±1.23, less 1-week complications limited to Bruising and Ecchymosis in five (23.8%) cases, superficial phlebitis in three (14.28%) cases, developed thrombosis in two (9.52%) cases, or skin burn in one (4.76%) case. Rapid return to normal activity (5.8±1.5) and overall results were better in group B, 19 (90.47%), compared with group B, 14 (66.66%), with a P-value of 0.001. Conclusion EVLA of GSV, being simple to perform and well accepted by patients, is a safe and effective method with low rate of complications, one-day hospitalization, short recovery time, and quick return to professional activities. For these reasons, this method is considered a very promising technique especially in female patients for cosmetic reasons as compared with surgical stripping.

Key concepts: Medicine, Varicose veins, Surgery, Reflux, Great saphenous vein, Ecchymosis, Ablation, Outpatient clinic

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