文献类型：期刊文献

英文题名：The first meta-analysis research on the effects of endovenous laser ablation combined with sapheno-femoral junction high ligation of the great saphenous vein

作者：Huang, Yalong[1,2];Zhang, Dengxiao[2,3];Zhou, Cong[1,2];Zhang, Yuan[4];Shi, Chaohai[3];Chen, Quan[4]

第一作者：黄亚乐;Huang, Yalong

通信作者：Chen, Q[1]

机构：[1]Gansu Univ Tradit Chinese Med, Clin Med Coll 1, Lanzhou, Peoples R China;[2]Gansu Prov Hosp, Dept Vasc Surg, Lanzhou, Peoples R China;[3]Lanzhou Univ, Clin Med Coll, Lanzhou, Peoples R China;[4]Dongguan Peoples Hosp, Dept Intervent & Vasc Surg, Dongguan, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Dongguan Peoples Hosp, Dept Intervent & Vasc Surg, Dongguan, Peoples R China.

年份：2023

卷号：38

期号：1

外文期刊名：LASERS IN MEDICAL SCIENCE

收录：;Scopus(收录号：2-s2.0-85166514599);WOS:【SCI-EXPANDED(收录号:WOS:001042514700001)】；

基金：This work was supported by the Gansu Provincial People's Hospital Research Fund Project (21GSSYC-27).

语种：英文

外文关键词：Ablation; Varicose veins; Prognosis; Risk factors; Vascular surgical procedures; Meta-analysis

摘要：Endovenous laser ablation (EVLA) is a common minimally invasive technique used to treat varicose veins. The most commonly used laser wavelengths for EVLA/EVLT of varicose veins are 810 nm and 1470 nm. The laser pulse frequency is typically set to continuous wave (CW) mode, with a pulse duration of a few milliseconds (ms) delivered in a radial mode. The energy delivered per pulse is typically set between 40 and 120 Joules, with a power setting of 10 to 30 watts and an intensity setting of 40 to 120 J/cm(2). The controversy exists regarding the benefits of performing saphenofemoral junction (SFJ) ligation prior to EVLA to decrease the recurrence rate of varicose veins. This meta-analysis aims to investigate the effectiveness of combining EVLA with high ligation versus using EVLA alone in treating lower extremity varicose veins. We conducted a systematic search of four databases from their inception until July 1, 2022, for randomized controlled trials and prospective controlled trials evaluating the advantages and disadvantages of EVLA with or without high ligation for the treatment of lower extremity varicose veins. In analyzing binary data, rate difference (RD) is used, while odds ratio (OR) is used for evaluating the confidence interval (CI) of binary data. A P value of less than 0.05 is deemed statistically significant. Heterogeneity is assessed using the chi-square test. If the I-2 statistic, which reflects statistical heterogeneity, is greater than 50%, a random-effects model should be used. In the absence of significant statistical heterogeneity, a fixed-effects model should be used if I-2 is less than 50%. We used the Cochrane risk-of-bias tool to assess the quality of the studies and Review Manager 5.4 for the primary and secondary outcome analysis. The meta-analysis was conducted in accordance with the Cochrane Handbook. There were no significant differences in the rate of major complications (RR = 1.63; 95% CI, 0.40-6.69; P = 0.50) or in the frequency of minor complications (RR = 1.07, 95% CI, 0.87-1.31; P = 0.52) between the EVLA with high ligation (EVLA/HL) group and the EVLA group. However, the rate of vein occlusion was significantly lower in the EVLA group than in the EVLA/HL group (RR = 1.06; 95% CI, 1.03-1.09; P = 0.0004). Our meta-analysis indicates that combining EVLA with high ligation provides stable long-term clinical efficacy in treating varicose veins of the lower extremities, although it increases the invasiveness of the surgery. The use of EVLA alone may be less effective in preventing vein occlusion.