title: Comparison of endovenous laser ablation and high ligation and stripping for varicose vein treatment: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficiency and safety of endovenous laser ablation (EVLA) for primary lower extremity varicosities compared with high ligation and stripping (HLS).
  
  
  METHODS
  Prospective non-randomized studies and randomized control trials on comparison of EVLA and HLS in treating varicose vein were included in this study. A meta-analysis on the data of suitable 13 clinical trials was performed using the Mantel-Haenszel method and the risk ratio was calculated. Thirteen studies including a total of 2245 limbs were eligible for inclusion. Among them, 1128 limbs were treated with endovenous laser ablation, whereas 1117 were treated with high ligation and stripping. Primary outcome measures were technical success rates and recurrence rates at different follow-up duration and complication rates.
  
  
  RESULTS
  No significant difference in initial technical success rates, Procedural failures were more common following EVLA compared with conventional surgery at one- and two-year follow-up. However, the duplex-detected and clinical recurrence rate was similar between conventional surgery and EVLA after one and two years. No statistical significance was found in postoperative phlebitis and bruise in EVLA and HLS (17.9% versus 21.5%). However, fewer complications were observed in EVLA compared with HLS, including bleeding and haematoma (1.28% versus 4.83%), wound infection (0.33% versus 1.91%) and paraesthesia (6.73% versus 11.27%).
  
  
  CONCLUSIONS
  EVLA for varicose veins is safe and effective compared with HLS in a two-year range. More randomized controlled studies follow-up results are needed to clarify long-term recurrence (5 years).
authors: Department of Vascular Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
authors: Y
authors: Y
authors: Pan
authors: J
authors: J
authors: Zhao
authors: J
authors: J
authors: Mei
authors: M
authors: M
authors: Shao
authors: J
authors: J
authors: Zhang
mesh_terms: D003288:Contusions / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008026:Ligation / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D010689:Phlebitis / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012501:Saphenous Vein / Q000473:pathology*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000009:adverse effects / Q000379:methods*; D014648:Varicose Veins / Q000628:therapy*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*
keywords: endovenous laser treatment; meta-analysis; varicose vein