Abstract: Objective To compare the efficacy of endovenous laser therapy (EVLT) and high ligation and stripping (HLS) in the treatment of great saphenous varicose veins. Methods A retrospective case-control study was used to analyze the clinical data of 416 patients who received treatment for great saphenous varicose veins in Taizhou Second People's Hospital from January 2022 to December 2024. Patients were divided into two groups: 217 patients underwent EVLT (observation group) and 199 underwent HLS (control group). Baseline data (age, sex, BMI, affected side, CEAP classification), operative time, intraoperative blood loss, hospital stay, total treatment cost, postoperative complications, clinical efficacy, and 2-year recurrence rates were compared. Results There were no statistically significant differences in baseline data between the observation group and the control group.In the comparison of key perioperative treatment indicators, the operation duration,intra-operative blood loss, and postoperative hospital stay of the observation group were significantly less than those of the control group(P＜0.05),while the total treatment cost of the observation group was significantly higher than that of the control group(P＜0.05).In terms of postoperative complication incidence, the observation group had a significant lower rate (9.40%) as compared with the control group (20.20%)(P＜0.05). Regarding the total effective rate of treatment, the observation group achieved 98.29%, while the control group reached 96.97%. There was no significant statistical difference in the total effective rate between the two groups. As for the postoperative recurrence rate, the observation group had a rate of 8.55% and the control group 8.08%, with no significant difference. Conclusions Both EVLA and HLAS exhibit remarkable therapeutic effects in treating GSVV, with minimal saphenous nerve injury and low 2-year postoperative recurrence rate. Nevertheless, EVLA has more advantages during and after surgery in terms of less time for surgical operation, less intraoperative bleeding, shorter length of hospital stay, less postoperative complications and faster recovery.

Key words: great saphenous vein varicosities, endovenous laser therapy, high ligation and stripping, saphenous nerve injury, Enhanced Recovery After Surgery (ERAS)