Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2023; 11(35): 8291-8299
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8291
Endovenous laser treatment vs conventional surgery for great saphenous vein varicosities: A propensity score matching analysis
Qiang Li, Chen Zhang, Zhao Yuan, Zi-Qi Shao, Jian Wang
Qiang Li, Chen Zhang, Zhao Yuan, Zi-Qi Shao, Jian Wang, Department of General Surgery, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Co-first authors: Qiang Li and Chen Zhang.
Author contributions: Li Q and Zhang C contributed equally to this work; Wang J, Li Q and Zhang C conceptualized the study, retrieved, read, and summarized the articles, and wrote the manuscript; Li Q, Zhang C, Yuan Z, and Shao ZQ retrieved and summarized the articles and wrote the manuscript; Li Q and Zhang C reviewed and edited the manuscript and supervised the review and writing process; all authors contributed to the article and approved the submitted version.
Supported by the Excellent Talents Fund Project of Xuzhou Medical University, No. XYFY2021019.
Institutional review board statement: This study was approved by Ethics Committee of the Second Affiliated Hospital of Xuzhou Medical University, Approval No. [2021]090501.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 15005206620@163.com. Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Wang, MD, Dean, Doctor, Department of General Surgery, The Second Affiliated Hospital of Xuzhou Medical University, No. 32 Meijian Road, Xuzhou 221000, Jiangsu Province, China. 15005206620@163.com
Received: September 27, 2023
Peer-review started: September 27, 2023
First decision: October 9, 2023
Revised: October 22, 2023
Accepted: November 30, 2023
Article in press: November 30, 2023
Published online: December 16, 2023
Processing time: 78 Days and 2.7 Hours
ARTICLE HIGHLIGHTS
Research background

Great saphenous vein (GSV) varicosis is a common condition, predominantly affecting women. It can result in chronic ulcers, impacting patients' quality of life. Varicose veins affect a substantial portion of the adult population, necessitating effective clinical treatments.

Research motivation

Current surgical treatments, particularly high ligation and stripping, have limitations such as postoperative recurrence, slow recovery, and scarring. Minimally invasive endovenous laser treatment (EVLT) has gained popularity, with claims of better patient outcomes compared to conventional surgery (CS).

Research objectives

This study aims to compare perioperative and postoperative outcomes of EVLT and CS in GSV varicose vein patients, while mitigating bias through propensity score matching (PSM) to address confounding factors.

Research methods

Data from patients with GSV varicose veins treated at a specific medical center were retrospectively reviewed. Propensity score matching was used to ensure balanced groups, and statistical analyses were conducted.

Research results

Before PSM, EVLT showed benefits in surgical time, hospital stay, and invasiveness but was associated with higher recurrence rates and postoperative pain compared to CS. After PSM, there were no significant differences in hematoma incidence or local hematoma. However, EVLT continued to exhibit a higher recurrence rate and postoperative pain compared to CS.

Research conclusions

The study suggests that EVLT, while less invasive, may not always be the best choice for GSV varicose vein treatment due to higher recurrence rates and pain. The choice of treatment should be tailored to individual cases. Novel procedures with longer treatment lengths may offer future treatment strategies.

Research perspectives

The study's retrospective design and relatively small sample size pose limitations. Further refinements in both technique and technology are needed to enhance treatment outcomes. Surgeons should make treatment decisions on a case-by-case basis, considering the specific needs and characteristics of patients.