Comparison Of Recent Clinical Efficacy Between Endovenous Laser Ablation And Traditional Surgery In The Treatment Of Lower Extremity Varicose Veins (Inner Diameter ≥ 10mm)

Objective:To compare the recent clinical efficacy of endovenous laser ablation(EVLA)and traditional high ligation of great saphenous vein combined with superficial varicose vein stripping in the treatment of varicose vein with GSV ≥ 10 mm,and to summarize the research results,so as to provide assistance for clinicians in their selection.Methods:Data of patients with varicose veins of lower limbs who were treated in o ur hospital from July 2020 to February 2021 were collected,and 80 patients w ho met the diagnosis and inclusion criteria were randomly divided into study g roup(40 cases treated with EVLA)and control group(40 cases treated with hi gh ligation of great saphenous vein combined with superficial varicose vein stri pping).The patients were followed up at 1 month,3 months,6 months and 1year by outpatient or telephone,and the conditions of paresthesia(sapherous ne rve injury),subcutaneous sclerosis and clinical success(no new varicose veins in situ)in the operation area were recorded,and the postoperative venous clini cal severity score(VCSS)was performed.Results:1.Patients were followed up at 1 month,3 months,6 months and 1 year after surgery.The rate of paresthesia in the operation area of patients in the s tudy group was 7.5%,7.5%,5.0% and 2.5% respectively,and that of patients in the control group was 27.5%,25.0%,20.0% and 12.5% respectively.There was significant difference in the rate of paresthesia between the two groups at1 month,3 months and 6 months follow-up(P < 0.05),but there was no sign ificant difference in the rate at 1 year follow-up.2.Patients were followed up at 4 postoperative time points.The rates of subcutaneous sclerosis in the study group were 12.5%,10.0%,7.5%,2.5%,res pectively,and in the control group were 32.5%,30.0%,20.0%,10.0%,respecti vely.There was significant difference in the rate of subcutaneous sclerosis bet ween the two groups at 1 month and 3 months follow-up(P < 0.05),but ther e was no significant difference in the rate at 6 months and 1 year follow-up.3.Patients were followed up at 4 postoperative time points,the clinical su ccess rate of patients in the study group was 97.5%,90.0%,87.5%,80.0%,an d the clinical success rate of patients in the control group was 95.0%,95.0%,92.5%,and 90.0%,respectively.There was no statistical difference in the clinic al success rate between the two groups at each time point of follow-up.4.Patients were followed up at 4 postoperative time points,respectively,a nd the VCSS scores of patients in the study group and control group were sig nificantly lower than those before surgery,and there was no statistical differenc e between the two groups at each time point(P > 0.05).Conclusion:1.The results showed that there was no statistically significant difference in clinical success and VCSS score between EVLA and traditional surgery in p atients with GSV diameter ≥10mm.Therefore,we believe that both surgical methods are technically successful,and there are no major complications in a period of time;2.It was found in the study that patients with GSV diameter ≥ 10 mm w ho were treated with EVLA performed better than traditional surgery in terms of recent postoperative paresthesia and subcutaneous sclerosis.3.In the subgroup analysis of this study,it was found that EVLA in the treatment of overweight patients had significantly better performance than non-o verweight patients in the rate of subcutaneous sclerosis.Therefore,in clinical work,it is the optimal treatment plan to combine different surgical methods fo r different patients and adopt individualized treatment.