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Endovenous laser ablation (EVLA) for primary varicose veins is generally performed under local anesthesia as a day surgery ; however, additional therapy is often required for residual varices after the initial surgery. EVLA can also be combined with other surgical procedures to treat all causes of varices, including great saphenous vein (GSV) reflux, small saphenous vein (SSV) reflux, and incompetent perforating veins (IPVs), in a single operation. In this study, we performed EVLA and other surgical procedures concurrently to treat primary varicose veins under general anesthesia. All surgical procedures, including EVLA for over-the-knee GSV, invagination stripping or ligation of un-der-the-knee GSV or SSV, ligation of IPVs, and segmental varicectomy, were performed under general anesthesia with a three-day and two-night hospital stay. In the early postoperative period, complaints of pain at ablation sites were rare (5.6 %). Endovenous heat-induced thrombus and burn injuries of the skin were not observed. The rate of subcutaneous hemorrhage was high (74 %). Postoperative paresthesia occurred in 8 cases (3.2 %) after invagination stripping. On long-term observation, the recanalization of the GSV and recurrence of varices were not observed. Our surgery with EVLA and other surgical procedures facilitated the complete resolution of varicose veins in a single operation, without the need for any postsurgical treatment. Source

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