Comparative Study of Endovenous Laser Ablation versus Conventional Surgical Approaches for Varicose Vein Management at a Tertiary Care Center in Latur, Maharashtra, India

Dr. Meghraj Jayantilal Chawada, Dr. Mahammad Ismail B Walikar, Dr. Sandeep Jadhav, Dr. Chandrashekhar Halnikar, Dr. Abhijeet Wankhede

Abstract: Background: Varicose veins, a prevalent condition caused by chronic venous insufficiency, can impair daily functioning and reduce quality of life. Traditional surgical treatments such as high ligation and stripping have been widely used for decades. More recently, minimally invasive approaches like Endovenous Laser Ablation (EVLA) have been introduced, offering potential advantages in terms of reduced postoperative discomfort and quicker recovery. Methods: This study, conducted at a tertiary care hospital in Latur, Maharashtra, India, incorporated both retrospective and prospective methodologies. A total of 86 patients diagnosed with varicose veins were included, with 43 undergoing conventional surgery and 43 receiving EVLA. The primary outcome was the improvement in Venous Clinical Severity Score (VCSS) at six months post-treatment. Secondary outcomes included postoperative pain levels measured via the Visual Analog Scale (VAS), enhancements in quality of life, incidence of complications, and recurrence rates. Results: Patients treated with EVLA reported significantly lower postoperative pain scores (mean VAS ~2 vs. ~4, p < 0.05). Both groups demonstrated notable improvements in VCSS and overall quality of life, with no substantial difference. Conventional surgery was associated with slightly higher rates of complications such as bruising and hematoma. Recurrence rates at six months were 4% in the conventional surgery group and 3% in the EVLA group, showing no statistically significant variation. Graphical representations of these outcomes are included for better visualization. Conclusion: EVLA offers superior early postoperative outcomes, particularly in terms of reduced pain and faster recovery, making it a preferable minimally invasive alternative. However, both treatment modalities effectively improve VCSS and patient quality of life over time.

Keywords: Varicose veins, Endovenous Laser Ablation, Conventional surgery, Venous Clinical Severity Score, Postoperative pain