Comparative Evaluation of Minimally Invasive Surgical Methods for the Treatment of Varicose Vein Disease in the Lower Extremities
Kozhamkul A. Saduakas A. Berkinbay A. Pazilov S. Ibekenov O. Baymakhanov A.
2025National Scientific Medical Center
Journal of Clinical Medicine of Kazakhstan
2025#22Issue 566 - 72 pp.
Background: Varicose vein disease (VVD) of the lower extremities is a common vascular disorder that significantly impairs quality of life and may lead to serious complications such as thrombophlebitis, deep vein thrombosis, and chronic venous insufficiency. The development of minimally invasive surgical techniques, including endovenous laser ablation (EVLA), radiof requency ablation (RFA), and sclerotherapy, has offered alternatives to traditional open surgery, with potential advantages in reducing postoperative complications, shortening recovery, and improving functional and cosmetic outcomes. Objective: to perform a comparative evaluation of the efficacy, safety, and outcomes of minimally invasive surgical methods (EVLA, RFA, sclerotherapy) versus traditional surgery (ligation and vein stripping with or without phlebectomy) in the treatment of varicose vein disease of the lower extremities. Methods: A retrospective study was conducted at the National Scientific Center of Surgery named after A.N. Syzganov in Almaty, Kazakhstan, between January 2019 and December 2024. The study included 481 patients diagnosed with VVD, divided into two groups: Group 1 (TM, n=305) underwent traditional surgical treatment (ligation and vein stripping), while Group 2 (MIM, n=176) received minimally invasive interventions (EVLA, RFA, or sclerotherapy). No other endovenous techniques (such as mechanochemical ablation or cyanoacrylate closure) were available in our center during the study period, and therefore were not performed. Conservative treatment (compression therapy and venoactive medications) was routinely used in non-operative patients but was not included in the present interventional cohort. Data on demographics, CEAP classification, Doppler ultrasound parameters, intraoperative characteristics, postoperative complications, and recovery time were analyzed. Statistical analysis was performed using t-test, chi-square test, and logistic regression (p<0.05). Results: Minimally invasive methods showed significantly shorter operative times (43.2 vs. 78.6 min), less intraoperative blood loss (48.9 vs. 160.3 ml), and fewer complications (6.8% vs. 16.9%). Postoperative pain (VAS) and hospital stay were significantly lower in the minimally invasive group. However, traditional surgery was more often used in advanced cases (C3–C4 stages). Conclusion: Minimally invasive surgical methods for VVD are associated with fewer complications, faster recovery, and greater patient satisfaction. However, traditional approaches remain essential in severe cases. Individualized treatment planning based on clinical stage and patient characteristics is key to achieving optimal outcomes.
lower extremities , minimally invasive methods , sclerotherapy , surgical treatment , thrombosis , varicose veins
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NJSC «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
Doctoral Program, Kazakhstan Medical University “Higher School of Public Health,”, Almaty, Kazakhstan
JSC «Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
Department of Vascular Surgery, NJSC «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
Head of Strategic Development, NJSC «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
Faculty of Postgraduate Education, JSC «Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
NJSC «Syzganov National Scientific Center of Surgery»
Doctoral Program
JSC «Asfendiyarov Kazakh National Medical University»
Department of Vascular Surgery
Head of Strategic Development
Faculty of Postgraduate Education
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