Clinical Study On Whether Endovenous Laser Ablation Combined With High Ligation Of Main Trunk For Lower Extremity Varicose Veins

Objective: Compare the clinical efficacy of endovenous laser ablation combined with high ligation trunk and single endovenous laser ablation in the treatment of lower extremity varicose veins,and evaluate whether venous ablation without high ligation of the main trunk is effective in the near future.Methods: 54 patients with lower extremity varicose veins who met the inclusion criteria were randomly divided into two groups,the study group(endovenous laser ablation group,n = 25)and the control group(endovenous laser ablation combined with high ligation trunk group,n = 29).Depending on the condition of varicose veins in the calf,all patients were given individualized treatments,such as reflux perforator vein ligation,sclerotherapy,point-like stripping,etc.All patients received elastic stocking support for 3-6 months after surgery.Compare the difference between the two group of patients’ hospitalization time,operation time and pain degree on the first day after surgery.Patients in both groups came to the hospital for clinical and ultrasound examinations at 1 month,3 months,and 6 months after surgery,and the postoperative efficacy,complications,recurrence,and recanalization of the greater saphenous vein were recorded.Results: 1.Operation time and hospitalization time: The operation time of the study group(58.2 ± 8.2)minutes was shorter than that of the control group(77.8 ± 21.7)minutes.The hospitalization time of the study group(6.3 ± 1.4)days was shorter than that of the control group(8.4 ± 2.0)days.All the differences were statistically significant(P < 0.01);2.Postoperative pain degree: The pain score of the study group on the first postoperative day(2.3 ± 1.5)was lower than that of the control group(4.3 ± 1.6),and the difference was statistically significant(P < 0.01);3.Clinical efficacy: Comparing the two groups of patients within the group,the significant efficiency increased with the follow-up time,but the total effective rate was always 100%.There was no statistical difference(P > 0.05);The comparison between the two groups of patients showed that the total effective rate was 100%,the efficacy was equivalent,and the difference was not statistically significant(P > 0.05);4.Complications: Complications occurred in both groups during hospitalization and disappeared within 1 month after surgery,including subcutaneous bruising(36% in the study group and 31% in the control group),superficial thrombophlebitis(4% in the study group and 6.9% in the control group)and lower extremity deep venous thrombosis(0% in the study group and 3.4% in the control group),with no statistically significant difference(P > 0.05);5.Recurrence rate and trunk recanalization rate of great saphenous vein: The recurrence rate and trunk recanalization rate of great saphenous vein in the study group were 16%,and that of the control group were 6.9%.With the extension of follow-up time,there was no significant change in the state of recanalization.There was no significant difference in the recurrence rate and the recanalization rate of the great saphenous vein between the two groups(P > 0.05).Conclusion:1.Endovenous laser ablation without high mains ligation can shorten the operation time and hospitalization time,and reduce postoperative pain.2.Endovenous laser ablation without high main ligation trunk has no significant effect on clinical efficacy in the near future,and can achieve better clinical results.3.Endovenous laser ablation without high main ligation of the trunk will not increase the incidence of postoperative complications,and there is no significant effect on varicose veins recurrence and great saphenous vein trunk recanalization in the near future.