Comparison of Endovenous Laser Therapy and Traditional Surgical Techniques in The Management of Varicose Veins

Background: Varicose veins are a common chronic venous disorder characterized by tortuous, dilated superficial veins of the lower limbs, often resulting in pain, swelling, and ulceration. Conventional surgical treatment, such as high ligation and stripping, has been the traditional management method for decades. However, with advancements in minimally invasive techniques, Endovenous Laser Ablation (EVLA) has emerged as an effective alternative offering improved recovery and reduced morbidity. This study aimed to compare the outcomes of EVLA with conventional surgery in the treatment of varicose veins. Material and Methods: A prospective comparative study was conducted over a period of 10 months in the Department of General Surgery. A total of 80 patients diagnosed with primary varicose veins were included and randomly divided into two groups of 40 each. Group A underwent EVLA, while Group B received conventional surgery (high ligation and stripping of the long saphenous vein). Patients were evaluated preoperatively and postoperatively for operative time, hospital stay, postoperative pain (measured using Visual Analog Scale), complications, recurrence, and time to return to normal activity. Results: The mean operative time was significantly shorter in the EVLA group (52.6 ± 8.4 minutes) compared to the conventional group (70.3 ± 10.7 minutes). The mean postoperative pain score on day 1 was 3.2 ± 1.0 in Group A and 6.1 ± 1.3 in Group B (p < 0.001). Hospital stay duration was markedly reduced in the EVLA group (1.2 ± 0.4 days) compared to the conventional group (3.8 ± 0.7 days). Postoperative complications such as wound infection and bruising were less frequent in the EVLA group (10%) than in the conventional group (27.5%). Patients who underwent EVLA returned to normal daily activities within an average of 7.8 ± 2.3 days, whereas those who underwent conventional surgery took about 15.4 ± 3.1 days. Conclusion: EVLA offers a safe, effective, and minimally invasive alternative to conventional surgery for the treatment of varicose veins. It is associated with less postoperative pain, shorter hospital stay, fewer complications, and faster recovery, making it a preferred choice for most patients. However, long-term follow-up is necessary to evaluate recurrence rates and durability of the procedure compared to traditional surgery.

Keywords: Conventional surgery, Endovenous laser ablation, High ligation and stripping, Minimally invasive therapy, Varicose veins.