A Systematic Review And Meta Analysis Between Radiofrequency Ablation And Conventional Stripping For Great Saphenous Veins In Clinical Effects

Objecive : To evaluate the evidence derived from comparative studies about the clinical efficacy of radiofrequency ablation(RFA)and conventional high stripping and ligation(HSL)。Methods:We conducted a systematic review and meta-analysis of treatments for patients with chronic venous disease(CVD).We searched PubMed,Embase,the Cochrane Database,OVID,Wangfang and CNKI of systematic reviews for relevant English-language and Chinese-language studies published from January 2000 to October 2018.We included relevant randomized controlled trials(RCTs)and used RevMan 5.3 software to evaluate the operative time,complications,efficacy and the rate of recurrence.Results: Thirteen articles and eleven RCTs met inclusion criteria.There were 891 patients with 949 legs who underwent RFA and HSL,The majority had CEAP clinical class from 2 to 6.Meta-analysis evaluating radiofrequency ablation(RFA)with high stripping and ligation(HSL)revealed no difference in operative time[OR-1.03,95% CI(-18.76,16.69),P=0.91].There was a significantly higher rate of hematoma and infection for RFA vs HSL[OR 0.20,95% CI(0.10,0.37),P<0.05]、[OR 0.22,95% CI(0.06,0.79),P<0.05],but not between RFA and HSL The paresthesia rate was significant [OR 0.03,95% CI(-0.01,0.07),P=0.97].There was a significantly higher rate of thrombophlebitis with RFA [OR 3.05,95% CI(1.31,7.09),P<0.05] as compared with HSL.RFA compared with HSL was associated with faster return to normal activity and work[OR-3.60,95% CI(-6.00,-1.20),P<0.05]and[OR-6.57,95% CI(-10.69,-2.44),P<0.05],There was no difference in the rate of recurrent varicose veins between RFA and HSL[OR 0.86,95% CI(0.51,1.44),P=0.56].Conclutions: Radiofrequency ablation for treatment of chronic venous disease has a better short-term safety and clinical efficacy than conventional surgery.