Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany; Vein Center of the Departments of Dermatology and Vascular Surgery, Katholisches Klinikum Bochum, Germany.
Department of Vascular Surgery, St. Josef Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Germany.
Ann Vasc Surg. 2021 Jul;74:331-338. doi: 10.1016/j.avsg.2020.12.057. Epub 2021 Feb 3.
High-ligation and stripping (HL/S) and external valvuloplasty (eVP) with the implantation of an external device to restore the valve's function, are surgical methods to eliminate reflux at the saphenofemoral junction. Furthermore, redo-surgery (RedoS) can be performed in terms of same side groin recurrences. It is unclear, if there is a difference in quality of life (QoL) between these 3 surgical treatment options. Therefore, it was the aim of our study to elucidate QoL in patients before and after surgical treatment at the saphenofemoral junction by comparing HL/S, eVP, and RedoS.
A total of 303 participants (156 HL/S, 81eVP, 64 RedoS) were recruited during the daily clinical routine. QoL was measured at admission and 6 weeks after the surgical procedure by means of SF-12 (12 item short form health survey) and Aberdeen Varicose Vein Questionnaire.
The mean value of Aberdeen Varicose Vein Questionnaire was 14.5 (SD 2.1) preoperatively and 4.9 (SD 3.3) postoperatively in the HL/S group, 16.4 (SD 1.4) preoperatively and 6.8 (SD 2.5) postoperatively in the eVP group and 15.5 (2.2) preoperatively and 5.8 (SD 4.2) postoperatively in the RedoS group, which was statistically significant (P< 0.05) in all groups. Postoperatively, the mean values were statistically significant within the groups. Concerning physical aspects of the SF-12 we found a significant improvement in the RedoS group, while mental aspects were significantly better in the HL/S and eVP group postoperatively. Nevertheless, the clinical relevance of these SF-12 differences is questionable under consideration of the minimal important difference.
Varicose vein surgery leads to a significant improvement of QoL in all groups. The implantation of an external patch could have a negative influence in QoL.
高位结扎剥脱术（HL/S）和外部瓣膜成形术（eVP）联合外部装置植入以恢复瓣膜功能，是消除隐股静脉连接处反流的手术方法。此外，对于同侧腹股沟复发，可进行翻修手术（RedoS）。目前尚不清楚这 3 种手术治疗方案在生活质量（QoL）方面是否存在差异。因此，本研究旨在通过比较 HL/S、eVP 和 RedoS，阐明隐股静脉连接处手术治疗前后患者的 QoL。
在日常临床工作中，共招募了 303 名参与者（156 名 HL/S、81 名 eVP、64 名 RedoS）。在手术前后，使用 SF-12（12 项简短健康调查）和阿伯丁静脉曲张问卷测量 QoL。
HL/S 组术前平均阿伯丁静脉曲张问卷得分为 14.5（SD 2.1），术后为 4.9（SD 3.3）；eVP 组术前平均得分为 16.4（SD 1.4），术后为 6.8（SD 2.5）；RedoS 组术前平均得分为 15.5（2.2），术后为 5.8（SD 4.2），所有组均有统计学意义（P<0.05）。术后，组内平均得分均有统计学意义。关于 SF-12 的身体方面，我们发现 RedoS 组有显著改善，而心理方面，HL/S 和 eVP 组术后明显更好。然而，考虑到最小重要差异，这些 SF-12 差异的临床相关性值得怀疑。
静脉曲张手术可显著改善所有组的 QoL。植入外部补片可能会对 QoL 产生负面影响。
