الفهرس 
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Abstract
SUMMARY
rimary varicose vein disease constitutes one of the most
frequent inherited disorders worldwide; according to
previous epidemiological studies, varicose vein disease affects
10–20% of the population in the Western world and lower
prevalence in other parts of the world.
Conventional surgical management for varicose veins
entails flush ligation of the SFJ, LSV stripping and stab
avulsions of the varicosities. Although this surgical modality is
safe and effective at short-term and midterm follow-up, it is not
rare for recurrence, hematoma, and skin infection to occur after
the surgical procedure.
Rarely, massive bleeding due to injury to femoral veins,
or even to the femoral artery during surgery, and mortality from
pulmonary embolism and DVT can happen. Therefore, novel
treatment modalities have been developed over recent years to
overcome the limitations of conventional surgery.
Within the last two decades, radiofrequency ablation and
endovenous laser treatment (EVLA) have been introduced as an
important new endovenous ablative techniques for the
minimally invasive treatment of superficial venous reflux and
varicose veins. Therefore, we performed the present systematic
review and meta-analysis in order to evaluate the short and
long-term outcomes of EVLA compared to conventional
surgery.
P
Summary
93
In the present study, we included 17 reports of 11
eligible RCTs (Total No. of legs =2524). The majority of the
included studies were from the UK or Netherlands with sample
size ranged between 65 and 798 patients.
All included studies recruited patients with great
saphenous vein affection, except three studies which included
patients with small saphenous vein affection. In the present
systematic review and meta-analysis, the average age of the
patients ranged from 42-53 years old; while the majority of the
patients were females.
Overall, our analysis showed that eight RCTs reported
the clinical recurrence rates over the period of follow-up, After
two years of follow-up, the overall effect estimates favored
EVLA over surgery (P =0.04). In contrary, the overall effect
estimates did not favor EVLA over surgery at one year (P
=0.53) and five years (P =0.12).
On the other hand, the present study showed that five
RCTs reported the complete success rates over the period of
follow-up, After six months of follow-up, the overall effect
estimates favored EVLA over surgery (P =0.03). In contrary,
the overall effect estimates did not favor EVLA over surgery at
other time points. In the present systematic review and metaanalysis,
four RCTs reported the change of HVVSS at two
years of follow-up. The overall effect estimates did not favor
EVLA over surgery (P =0.73).
Summary
94
Our analysis showed that, after six months of follow-up,
the overall effect estimates did not favor EVLA over surgery.
Similarly, the overall effect estimates did not favor EVLA over
surgery at one year, two years, and five years.
In conclusion, EVLA is a safe and effective treatment
alternative for patients with primary varicose veins. The present
systematic review and meta-analysis show that EVLA has, at
least, comparable efficacy to conventional surgery in terms of
recurrence rates, disease severity, and quality of life. Further
high-quality long-term studies are still needed to confirm our
findings.