A comparison of endovenous laser ablation and conventional surgery in patients with varicose veins of the lower limbs

Abstract

Introduction. Even though EVLA is increasingly popular and together with other minimally-invasive techniques is rapidly replacing surgical stripping, surgical treatment is still widely used. Our study aimed to compare the clinical outcomes and the quality of life following either endovenous laser ablation (EVLA) or conventional surgery for varicose veins of the lower limbs.

Material and methods. This prospective non-randomised study included 299 patients, who were treated for symptomatic varicose veins of the lower limbs in two centres. In one, 159 patients underwent open surgery (the surgery group), while in the other, 140 patients received the EVLA (the EVLA group). The patients were invited to follow-up evaluations at six weeks, one year, and two years after the surgery.

Results. Disease-specific quality of life at six weeks was significantly better in the EVLA group (median AVVQ scores — 3.2 (2.1–8) vs. 9.2 (7.1–13.8), p < 0.001). Similarly, VCSS scores at six weeks were also better in the EVLA group (median VCSS scores — 1 (0–2) vs. 4 (3–6), p < 0.001). Patients in the EVLA group experienced less postoperative pain (p < 0.001), and therefore needed fewer supplementary analgesic drugs (p = 0.007). In addition, patients in the EVLA group managed to return to work and normal activities sooner than those in the surgery group (p < 0.001). No statistically significant differences were found between groups for clinical recurrence, overall satisfaction, rate of complications and secondary procedures.

Conclusions. Both treatment techniques yielded similar results in terms of efficacy, clinical recurrence rates and overall patient satisfaction. However, early postoperative results in the EVLA group were superior to those of patients in the surgery group.