COMPARATIVE ANALYSIS OF ENDOVENOUS ELECTRIC WELDING AND ENDOVENOUS LASER COAGULATION IN VARICOSE VEIN TREATMENT

Rationale. The key task of surgical treatment of varicose vein (VV) is the elimination of the main pathogenetic factor – reflux over the great saphenous vein (GSV). Currently, the method of choice for varicose veins treatment is endovenous laser coagulation (EVLC), the experience of which has demonstrated the improvement of the results of VV treatment due to a significant reduction of the intervention traumatism, shortening the time for patients rehabilitation, and improving the cosmetic effect. However, there are some unresolved questions connected with choice of the dose of energy exposure and the high cost of treatment. Solving the problem of searching for a new reliable, safe and more economical method for eliminating vertical reflux can be the proposed method of endovenous electric welding (EVEW), in which the occlusion of GSV is realized by applying a fundamentally new technology - living tissue electric welding (LTEW) Objective: to perform a comparative analysis of the clinical application results of the EVEW and EVLC in the surgical treatment of VV. Materials and methods: In the course of the study, the results of treatment of varicose vein of С2–С3 clinical classes were analyzed in 126 patients, divided into two representative groups. In the main group, the EVEW method (62 patients) was applied, in the comparison group – the EVLC method (64 patients). The comparison was performed according to the time of the operative intervention, the subjective evaluation of the intensity of the postoperative pain syndrome, the final anatomical results of the intervention and complications. Results and discussion: As a result of the study, it was revealed that during the use of the EVEW the time of the operation was reduced by an average of 13.1 minutes. The postoperative pain syndrome in the main group was more moderate and had short duration. The incidence of occlusion with fibrotic transformation of GSV after 12 months of intervention in patients of both study groups did not have significant difference. At that time, persistent occlusion was observed in 6 patients from the main group with a maximum diameter of GSV on the hip from 16.2 to 22.2 mm. It was also noted that the frequency and duration of complications in the patients of the main group were lower than in the comparison group patients. Conclusions: The use of the EVEW method in the treatment of VV is no less effective, but safer in comparison with EVLC. The comparatively low temperature regime of the action of the EVEW allows for an operative intervention without using of tumescent anesthesia. The advantages of EVEW in the treatment of VV consist of a more perfect control algorithm, an effective impact on the vein with a diameter of more than 20 mm, a decrease in the level and duration of postoperative pain syndrome, and a reduction in the incidence of complications.