Comparative Study On The Efficacy Of Endovenous Laser Ablation And Conservative Surgery In The Treatment Of Great Saphenous Vein Varicosity

Objective:To analyze the clinical efficacy of endovenous laser ablation(EVLA)and conservative surgery(CS)in the treatment of varicose veins of the lower extremities,and to compare the advantages and disadvantages of the two different surgical methods as well as the difference of their postoperative complications.Methods:A total of 286 patients with primary varicose great saphenous vein in a single lower extremity admitted to Nanchong Central Hospital from January 2019 to December 2020 were retrospectively analyzed and divided into two groups according to different surgical methods:the EVLA group and the CS group,of which 195 cases were in the EVLA group(25 cases without high ligation of the great saphenous vein)and 91 cases were in the CS group.The EVLA group received endovenous laser ablation+high ligation+sclerosing agent for trunk and some branches(some of them were not treated with high ligation),while the CS group received high ligation+trunk stripping+punctate stripping+ sclerosing agent.The differences in postoperative hospital stay,intraoperative blood loss,total duration of surgery,total treatment cost,postoperative complications and recurrence rate within 6 months of the two surgical methods were compared and analyzed.Results:A total of 286 patients with primary varicose veins in a single lower extremity were enrolled in this study.No statistically significant difference can be observed in the comparison of general data such as gender,age,and CEAP classification between the two groups(P>0.05).The EVLA group has obvious advantages over the CS group in terms of surgery time(51.89±7.973min vs.65.43±8.938min,P<0.05),intraoperative blood loss(23.56±5.187ml vs.47.69±10.704ml,P<0.05),and postoperative hospital stay(4.52±0.568d vs.6.08±0.734d,P<0.05).There are obvious advantages in three aspects,but the treatment cost of the EVLA group was significantly higher than that of the CS group(RMB 14359.40±1009.53 vs.RMB 11751.90±1068.55,P<0.05).There were no postoperative complications such as deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis and incision infection in both groups.No significant difference was observed in pigmentation between the CS group and the EVLA group(P>0.05).However,there were significant differences in the complications of subcutaneous congestion(14.3%vs.3.6%),paresthesia(13.2%vs.2.1%),and postoperative pain(39.6%vs.10.3%)between the CS group and the EVLA group(P<0.05),and the CS group had a higher incidence.During the 6-month follow-up observation,none of the 195 patients who underwent EVLA had postoperative recurrence,and 95 patients underwent CS had only one recurrence,but the difference was not statistically significant(P>0.05).Conclusion:EVLA boasts certain advantages over conservative surgery.Despite no obvious difference being seen in the short-term recurrence rate after surgery between the two surgical methods,EVLA is characterized by less postoperative bleeding,shorter duration of surgery and shorter length of hospital stay.At the same time,patients who undergo EVLA have fewer complications such as postoperative pain,subcutaneous congestion,and paresthesia.Therefore,EVLA deserves to be further promoted in clinical practice because of its significant advantages.