Comparative Study of Postoperative Complications of High Ligation and Stripping with Endovenous Laser Treatment for Varicose Veins

ABSTRACT

PURPOSE: Endovenous laser treatment (EVLT) has been performed as a minimally invasive alternative to conventional surgery for saphenous vein incompetence. It is thought to minimize postoperative complications and improve the quality of life compared with high ligation and stripping. The aim of this retrospective study was to compare the postoperative complications and quality of life of EVLT with high ligation and stripping (HS). METHODS: A total of 294 patients with 390 saphenous veins were included in this study. Patients with saphenous vein incompetence were treated with either HS (n=98; HS group) or EVLT (n=196; EVLT group). Patients were evaluated preoperatively and at 1, 3 months, postoperatively. Postoperative complications, the Venous Clinical Severity Score (VCSS) and the Aberdeen Varicose Vein Symptom Severity Score (AVSS) were compared between the two groups. RESULTS: The total postoperative complication rate was 31.62%, in HS and 27.47% in the EVLT groups. Most of the complications were minor and self-limited. There were no statistical differences in the total complication rate and the occurrence of complications such as hematoma, paresthesia and phlebitis. Pain was less severe following EVLT compared to HS. The EVLT patients were discharged and resumed their normal activity earlier than the HS patients. The two groups had similar improvement of the VCSS and AVSS at 1 and 3 months, postoperatively. CONCLUSION: With the similar, comparable short-term safety outcome, both HS and EVLT may be considered as safe procedures for the treatment of varicose veins. Long-term, large population-based randomized studies with promising data for the improvement of quality of life scores will be needed for the evaluation of EVLT before it becomes a standard treatment for saphenous vein incompetence.