Objective  To retrospectively analyze the therapeutic effects of endovenous laser treatment (EVLT) or combined with subfascial endoscopic perforator surgery (SEPS) for varicose great saphenous vein and calf incompetent perforator vein.   Methods  The diagnosis was confirmed by ascending venography. Ultrasound scanning was used to exclude incompetent small saphenous vein and deep vein. From June 2003 to May 2006

186 patients were randomly assigned to undergo EVLT (n=98) and EVLT+SEPS (n=88). The clinical and demographic data of two groups showed no significant difference. The duration of follow-up varied from 3 to 32 months.   Results   After treatment

the varicose veins of two groups were relieved completely

without significant difference in relief of pain

edema or itching. The ulcers all healed

yet the healing time of ulceration

postoperative hospital stay and recurrence rate of ulcers in the patients receiving EVLT+SEPS were less than that by EVLT.    Conclusion   For the patients who had varicose great saphenous vein and calf incompetent perforator vein

but without ulceration

surgery for superficial veins alone is appropriate. However

for those with ulceration

surgery for superficial vein and incompetent perforator vein is definitely needed. EVLT is safe and effective in the treatment of varicose superficial vein

and EVLT +SEPS is a good choice in managing varicose vein of lower extremity with ulceration.