Endovenous Laser Therapy VS Traditional Stripping Operation For Varicose Veins: A Systematic Review

Objective: To compare the clinical efficacy and safety of Endovenous Laser Treatment (EVLT) with traditional stripping operation on treatment of varicose veins.Methods: Search published studies in reporting varicose veins which treated with traditional stripping operation and EVLT were obtained from a search of database such as MEDLINE,CENTRAL,EMBase and so on. Relevant journals were also hand searched until March 2010.We collected randomized controlled trials (RCTs) comparing EVLT with traditional stripping operation for varicose veins. Study selection and quality assessment, data extraction and analysis were undertaken by two reviewers independently according to the Cochrane Handbook for Systematic. Reviews of interventions, Meta-analysis were also performed.Results: Our search identified 6 randomized controlled trial studies, involving 536 patients, 691 treated limbs, with CEAP classification mostly inâ…¡. But most included trials were of low quality and small sample. Until now, there were not all clinical trials with multicentre, large sample or high quality. Overall, the 6 Months Duplex results vein bloodstream rates were not different(RR= 1.91 , 95%CI = [0.14,26.00] , P > 0.05),12 Months Duplex results vein bloodstream rates were not different (RR=0.57,95%CI=[0.24,1.35],P=0.20)and Complete occlusion at the end of follow-up for stripping and laser therapy were not distinctive(OR=1.03,95%CI=[0.23,4.70],P=0.97). And there is no significant differences between traditional stripping operation and EVLT in the superficial thrombophlebitis , Phlebitis, and infection , but EVLT are better than traditional stripping operation over swelling, bruising, paresthesia,operation time,quality of life,and discharge time. However, the evidence is not strong enough because of some of the low-quality trials and publications bias. More rigorous designs, large sample, multicentre, randomized, double-blind trials are needed to further assess the effect.Conclusion: Our results suggest that EVLT management of varicose veins is no differences with stripping operation in effective, but less complications. We suggest that EVLT is a safe, effective and minimal invasive method of treatment, and will becoming the first choice of varicose veins.