Comparison of traditional surgery and laser treatment of incontinent great saphenous vein. Results of a meta-Analysis


COD: 01_2016_1166_2366 Categorie: ,

Gennaro Quarto, Bruno Amato, Umberto Giani, Giacomo Benassai, Emanuele Gallinoro, Marco Apperti, Ermenegildo Furino

Ann. Ital. Chir., 2016 87: 61-67

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AIM: This paper aims to compare EVLA to traditional surgery, by evaluating the incidence of recurrences.
MATERIAL OF STUDY: We performed a meta-analysis to challenge both surgical and LASER treatment, using, as clinical
outcome, the presence or the absence of reflux. A systematic review of literature about the treatment of varicose veins
was performed, searching in the following databases: PUBMED-MEDLINE, Cochrane Library. Search terms considered
were: stripping, HL/S, surgery, LASER, EVL*, varicose vein, GSV, saphenous vein. Only RCTs based at least on sixmonths
follow-up were considered eligible in the study. Methodological quality of the included studies was evaluated using
Cochrane Collaboration Bias Risk Assessment Tool. Effects of the dichotomous variables taken in consideration were evaluated
using pooled risk-ratios with 95% C.I. Articles were evaluated initially from abstracts; eligible papers were fulltext
RESULTS: We have considered 2 groups, A and B. A Group: 756 legs treated with conventional surgical procedure; B
Group: 755 legs treated with EVLA technique. A Group showed 175 post-procedure recurrences, while B showed 97
recurrences. The average O.R. was 1.72; minimum O.R. was of .497 while the maximum was of 8.064.
DISCUSSION: The obtained OR average value is 1.72 with a 95% C.I. of 0.94-3.12, which includes the value 1, contrary
to the criteria for rejection of the null hypothesis. For this reason there is not a statistically significant difference
between the results obtained by the two techniques.
CONCLUSIONS: The endovascular laser ablation (EVLA) does not prove to be superior in terms of recurrence, to the surgical
technique. However, it remains a viable treatment option in patients with impaired great saphenous vein, reducing
postoperative pain and hospital stay.