2014 Volume 25 Issue 4 Pages 391-395
Objective: To evaluate the efficiency and safety of endovenous laser ablation (EVLA) compared with high ligation and stripping (HL/S) for primary varicose vein, and evaluate the role of EVLA in the foundation hospital. Methods: A total of 99 patients (108 limbs) with primary symptomatic great saphenous vein reflux were treated with EVLA (EVLA groups). Thirty-nine patients (41 limbs) who received HL/S (HL/S groups) last one year before starting EVLA were enrolled to compare operative outcome of HL/S with that of EVLA. Results: No statistically significant differences were noted between the two groups with respect to preoperative background (age, sex ratio, preoperatice clinical, etiologilal, anatomical and pathological [CEAP] classification). All EVLA procedures were performed under tumescent local anesthesia, while HL/S was performed under spinal anesthesia. In all treated limbs, occlusion was demonstrated ultrasonographically immediately after the procedure. After three months, all of the treated veins remained occluded. No statistical significance was noted in rated of postoperative complications between EVLA and HLS. The mean operating-room time was 54.1 min in the EVLA group and 102 min in the HL/S group (p<0.0001). EVLA required significantly fewer operating-room staff, including physicians, nurses, and sonographers, than in HL/S (3.8 people vs. 6.2 people; p<0.01). Mean hospital stay was also shorter in EVLA than in HL/S (2.1 days vs. 3.9 days; p<0.01). Given the above, the index of person-minutes was consequently four times higher in HL/S than in EVLA (176.2 vs. 632.4; p<0.0001). Conclusion: EVLA is not only as efficient and safe as HL/S in terms of clinical outcome but can also be performed in less time and with fewer operating staff than HL/S. EVLA is four times more effective than HL/S with respect to personnel expenses.
