The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Randomized clinical trial of radiofrequency ablation or conventional high ligation and stripping for great saphenous varicose veins. BJS 2010; 97: 328-336.

Published: 24th December 2009

Authors: S. Subramonia, T. Lees

Background

This randomized clinical trial compared early outcomes after radiofrequency ablation (RFA) and conventional surgery for varicose veins.

Method

Consecutive patients with symptomatic varicose veins due to isolated great saphenous vein (GSV) incompetence and suitable for RFA were randomized to either RFA or conventional surgery (saphenofemoral disconnection and stripping). Clinical, radiological and patient‐based outcomes were recorded at 1 and 5 weeks after intervention.

Results

RFA resulted in successful obliteration of the GSV in all 47 patients. Complete above‐knee stripping was unsuccessful in seven of 41 patients. RFA took longer than conventional surgery: median interquartile range 76 (67–84) versus 48 (39–54) min; P < 0·001. Patients returned to their normal activities significantly earlier after RFA (median 3 (2–5) versus 12·5 (4–21) days; P < 0·001). Postoperative pain was significantly less after RFA (median score on visual analogue scale 1·70 (0·50–4·30) versus 4·0 (2·35–6·05); P = 0·001). Patient satisfaction, quality of life improvement and analgesic requirements significantly favoured RFA.

Conclusion

RFA took longer to perform but resulted in a significantly better early outcome than conventional surgery in suitable patients with great saphenous varicose veins. Registration number: ISRCTN29015169 (http://www.controlled‐trials.com). Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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