Meta-Analysis Of Randomized Controlled Trials Between Endovenous Procedure And Conservative Surgery In The Treatments Of Varicose Veins

Objectives In this study we summarize the available evidence derived from comparative studies about the relative efficacy and racurrence of endovenous procedure(ultrasound-guided foam sclerotherapy (UGFS), endovenous laser ablation (EVLA) and radiofrequency ablation (RFA))and conservative surgery.Methods Databases including PubMed, EMbase, Ovid medline and Cochrane Central were searched from2000.1to2012.12to collect the randomized controlled trials(RCTs) comparing UGFS,EVLA,RFA, and surgery or combinations of these for treatment of varicoses. Two independent reviewers determined study eligibility and extracted descriptive,methodologic, and outcome data. We used random-effects meta-analysis to pool relative risks (RR) and95%confidence intervals (CI) across studies.Meta-analysis was performed using RevMan5.2.Results22eligible studies (25randomized controlled trials) was found. Surgery was associated with a non-significant reduction in the risk of primary failure compared with UGFS (RR=3.42[95%CI:2.21,5.29] P<0.05) and RFA (RR=1.32[95%CI:0.83,2.08] P=0.24). The endovenous procedure had advantages over surgery in primary failure:RR=0.88[95%CI:0.63,1.22] P=0.45(EVLA) recurrence rate:RR=0.70[95%CI:0.49,1.02] P=0.06(EVLA), haematoma:RR=0.52[95%CI:0.35,0.77] P<0.05(EVLA)&RR=0.13[95%CI:0.06,0.30] P<0.05(RFA),infections:RR=0.35[95%CI:0.12,1.07]P=0.07(EVLA)&RR=0.36[95%CI:0.10,1.32] P=0.12(RFA) and paresthesiaRR=0.69[95%CI:0.53,0.90] P<0.05(EVLA).Conclusion There is no significantly difference of primary failure and recurrence rate compared UGFS,EVLA and RFA with surgery.However,the endovenous procedure brought us lower recurrence rate,less haematoma and infections.