The Efficacy And Complications Of Endovenous Radiofrequency Ablation V.S. Endovenous Laser Ablation In The Treatment Of Varicose Veins Syndrome Of Lower Extremities

Research background:Varicose vein syndrome is a common disease in dermatology,which has a chronic course with no obvious symptoms and irreversible progression,even with serious complications and sequelae,which seriously endangers the quality of life of patients and brings a heavy burden to families and society.The current treatment trend is based on various minimally invasive endovenous surgical techniques,of which endovenous laser ablation(EVLT)is the classical procedure and radiofrequency ablation(RFA)is a newer technique,both of which are recommended as first-line treatment in the guidelines.The latter is expected to have better advantages,which are yet to be verified by more studies.This study was designed as a prospective cohort study of these two thermal ablation treatment modalities.Research object:In this study,we investigated the advantages and disadvantages of RFA and EVLT in the treatment of varicose vein syndrome of the lower extremities by observing two groups of patients with lower extremity venous syndrome treated with RFA and EVLT respectively,and provided more reference basis for the selection of minimally invasive surgery for varicose veins of the lower extremities by comparing the differences between the two groups in terms of efficacy and complications.Research subjects and methods:According to the diagnostic criteria,inclusion criteria and exclusion criteria,the clinical data of 38 patients(56 affected limbs)with saphenous varicose veins treated with RFA and EVLT in the Department of Dermatologic Surgery and Department of Vascular Surgery of Sichuan Provincial People’s Hospital between December 2021 and December2022 were collected and divided into radiofrequency and laser groups according to the surgical modality adopted.In the radiofrequency group,12 patients with 18 affected limbs were included,and radiofrequency ablation of the saphenous vein was the main surgical method;in the laser group,26 patients with 38 affected limbs were included,and laser ablation of the saphenous vein was the main surgical method.The differences in the venous clinical severity score(VCSS),chronic venous insufficiency questionnaire(CIVIQ),postoperative complications,visual analogue scale(VAS)for pain 24 hours after surgery,duration of surgical pain,use of postoperative pain medication,time to surgery,cost of treatment,patient satisfaction,and time to return to daily life were compared and analyzed between the two groups.All these scores were positively correlated with the condition.Statistical methods: SPSS26.0 software was used for statistical analysis and processing,and the chi-square test was used for count data,and Fisher’s exact probability method was used if the number of cells with theoretical frequencies less than 5 exceeded20% or the total number of samples was less than 40;mean±standard deviation(Mean±SD)was used for measurement data obeying normal distribution,and median(interquartile spacing)was used for obeying skewed distribution M(P25,P75)was expressed,and t-test was used for measurement data obeying normal distribution,otherwise non-parametric test was used;rank sum test was used for rank data;repeated measures ANOVA was used for VCSS scores and CIVIQ scores at different time points of the two treatment groups,and simple effect analysis was used for two-way comparison.Differences were considered statistically significant at P < 0.05.Research result:1.The general data(age,disease duration,gender,affected side,CEAP classification)of the two groups were not statistically different(P > 0.05),and the two groups were comparable.2.By comparing the preoperative and postoperative VCSS scores and CIVIQ scores of the two groups,it was found that the VCSS scores and CIVIQ scores of the two groups were significantly lower than those of the preoperative group one week after surgery,one month after surgery,and three months after surgery,and the differences were statistically significant(P < 0.05);the comparison of VCSS scores and CIVIQ scores between the two groups one week after surgery and one month after surgery were not statistically different(P > 0.05),while the scores of the laser group were significantly lower than those of the RF group in March after surgery,and the differences were statistically significant(P < 0.05).3.The complication rate was lower in both surgical modalities,and there was no statistical difference in the comparison of complications(petechiae,edema,and sclerosis)between the two groups in this study(P > 0.05).4.The postoperative pain VAS scores were lower in the RFA group than in the EVLT group(P < 0.05),and the duration of surgical pain was shorter(P < 0.05).However,the use of postoperative pain medication was not observed in either group.5.The treatment cost was higher in the RFA group(P < 0.05)and the duration of surgery was longer(P < 0.05)than in the EVLT group.6.Overall patient satisfaction was higher in both treatment modalities and the time required to resume daily life was shorter in both groups,but there was no statistical difference in the comparison of overall satisfaction and time required to resume daily life in both groups(P > 0.05).Research Conclusion:In this study,by comparing the efficacy and complications of the two mainstream thermal ablation techniques for varicose veins in the lower extremities,mainly RFA and EVLT,we found that both treatment modalities were effective,with fewer complications and higher safety,generally higher patient satisfaction,and less and shorter postoperative impact on patients’ lives.The EVLT group had better long-term outcomes than the RFA group,and although the RFA group had higher treatment costs and longer and more complex operation times,the RFA group had less surgical pain.