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ENDOVASCULAR VENOUS LASER VS OESCH PIN STRIPPER IN MANAGEMENT OF PRIMARY VARICOSITIES OF THE GREAT SAPHENOUS VEIN: A RANDOMIZED CONTROL TRIAL
Author(s) -
Desai D. J.,
Pedgoankar P.,
Sekhar R.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04935_8.x
Subject(s) - medicine , great saphenous vein , surgery , ecchymosis , reflux , randomized controlled trial , varicose veins , randomization , disease
Aim: Varicosities of the lower limb are a major economic and medical burden. Various modalities of treatment have been proposed. This study aims to compare minimally invasive Endovenous Laser Ablation (EVLA) with conventional High ligation and stripping using Oesch Pin stripper (HLS) in the management of primary varicosities of the Great Saphenous vein (GSV). Principal outcomes were abolition of GSV reflux and comparison of postoperative morbidity and mortality. Material and Methods: This trial was prospectively conducted over 2 years and comprised to a total of 60 consecutive consenting patients randomized (randomized by a random number assigned by a blinded person) equally between the EVLA and Surgery groups. The inclusion criteria were patients with symptomatic primary GSV reflux and varicosities suitable for both modalities of treatment. Exclusion criteria were secondary GSV varicosities and recurrent varicosities. All patients were followed up at regular interval for a period of 3 months. Results: GSV reflux was abolished in all patients in both groups. Patients with EVLA had a shorter length of stay (LOS) of 0.47 compared to 2.6 with HSL. One patient had minor burns with EVLA and in one venotomy had to be done due to slippage of guide wire. All other post‐operative complications such as haematoma, ecchymosis, and pain were significantly lower in the EVLA group. There was no mortality in either group. Conclusion: EVLA being an outpatient procedure resulted in a safer and quicker recovery and less socioeconomic burden with a shorter LOS, however the early peri‐operative pain was higher in the EVLA group. The long term results of recurrence have not been studied in this study and warrants further investigation.