Résumé
Objective To compare the efficacy of holmium laser and traditional surgery for the treatment of varicosis of the lower limbs.Methods From March 2005 to December 2006,226 patients with varicosis of the lower limbs(274 limbs)were treated using holmium laser(laser group,120 patients with 148 diseased limbs)or high ligation and stripping of the great saphenous vein(traditional group,106 patients with 126 diseased limbs).Results The mean operation time of the laser group was significantly shorter than that in the traditional group [(38.0?10.8)min vs(61.5?12.3)min,t=-15.294,P=0.000].None of the patients in the laser group need analgetics after the operation,while 58 patients in the traditional group received the drug after the surgery(0 vs 54.7%,?2=88.329,P=0.000).The patients in the laser group returned to activities earlier and had shorter postoperative hospital stay than those in the traditional group [(6.2?0.8)h and(3.0?0.5)d vs(22.5?1.5)h and(8.5?2.5)d;t=-105.034,P=0.000 and t=-23.632,P=0.000,respectively].The rates of complications and 1-year recurrence were similar in the two groups [16.9%(25/148)vs 18.3%(23/126),?2=0.087,P=0.768 and 3.8%(3/78)vs 3.1%(2/65),?2=0.000,P=1.000].Conclusions Holmium laser has advantages of shorter operation time and hospital stay,fewer surgical incisions,milder postoperative pain,and earlier return to activities.Closure of the great saphenous vein is the key to ensure the effect of laser therapy.High ligation of the great saphenous vein should be done simultaneously if necessary.