Comparison Of The Efficacy Of Endovenous Laser Ablation And Radiofrequency Ablation In The Treatment Of Varicose Veins

Objective Varicose veins is a common disease in vascular surgery.At present,in addition to conservative treatment,surgical treatment is mostly used for the treatment of great saphenous vein varicose.Due to the slow recovery and large trauma of traditional surgery,with the progress of technology,many minimally invasive surgical treatments have been developed,among which intracavitary thermal ablation has gradually been widely recognized and applied.Through the collection and analysis of clinical cases,this study evaluated the clinical efficacy of laser ablation and radiofrequency ablation without ligation of the main trunk of the great saphenous vein,and summarized and analyzed the effectiveness,safety,advantages and disadvantages of the two surgical methods.Methods A total of 114 patients with varicose great saphenous vein who met the inclusion and exclusion criteria admitted to the Vascular Surgery Department of Shenzhen Second People’s Hospital from August 2021 to August 2022 were collected and divided into laser group and radiofrequency group according to different treatment methods.In the laser group,56 cases(60 affected limbs)were treated by laser occlusion of the great saphenous vein + injection of foam hardener + superficial vein point stripping,while 58 cases(62 affected limbs)were treated by radiofrequency ablation of the great saphenous vein + injection of foam hardener + superficial vein point stripping.Through the operation time,intraoperative blood loss,postoperative hospital stay,hospitalization cost,postoperative pain score,postoperative complications(skin ecchymosis hematoma,thrombotic phlebitis,lower limb skin sensory disturbance,skin burns,wound infection and deep vein thrombosis,etc.),preoperative and postoperative VCSS and CIVIQ scores,the great saphenous vein occlusion rate and recurrence rate,to summarize the clinical characteristics and therapeutic effects of the two surgical methods.Result(1)There was no obvious difference between laser group and radio-frequency group in gender,age,course of disease,distribution of affected limb and clinical CEAP grade(p > 0.05).(2)There was no obvious difference in operative blood loss,duration of surgery,length of postoperative stay,preoperative and half-year postoperative VCSS and CIVIQ scores,postoperative great saphenous vein occlusion rate and recurrence rate between the laser closure group and radiofrequency ablation group(p>0.05).(3)The postoperative pain and skin ecchymosis hematoma in the laser group were more than those in the radiofrequency group(p <0.05).The hospitalization cost of the laser group was lower than that of the radiofrequency group,and the difference was statistically significant(p < 0.05).Conclusions(1)Laser ablation and radiofrequency ablation have the advantages of less trauma,faster recovery and fewer complications.Both of them have definite short-term efficacy and similar efficacy and safety,but the long-term closure rate and recurrence rate need to be further observed with longer follow-up time.(2)Compared with laser ablation,radiofrequency ablation has less postoperative pain,lower incidence of minor complications such as skin ecchymosis and hematoma,but the treatment cost is relatively high.In clinical practice,individualized treatment can be selected according to the patient’s condition and willingness.