Hospital Israelita Albert Einstein, Divisão de Cirurgia Vascular, São Paulo, São Paulo, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo - USP, São Paulo, São Paulo, Brazil.
Hospital Israelita Albert Einstein, Divisão de Cirurgia Vascular, São Paulo, São Paulo, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, São Paulo, Brazil.
Ann Vasc Surg. 2022 Mar;80:60-69. doi: 10.1016/j.avsg.2021.10.029. Epub 2021 Nov 13.
In the Brazilian public health system, conventional surgery is the standard procedure for treatment of varicose veins (VV). We aimed to compare clinical and quality of life (QoL) results of patients subjected to bilateral treatment of VV by a single-procedure or staged-procedure approach.
A total of 111 patients undergoing bilateral treatment for VV were treated either by a single-surgery or 2 staged procedures (minimal: 30-day interval) depending on institutional protocol. Patients were evaluated with respect to clinical symptoms and quality of life markers before and after treatment, by use of the VEINES-Sym/QoL and EQ5D-5L scores, and these results were then compared between groups.
QoL scores improved in general after treatment. VV specific symptoms and QoL aspects improved equally between the Staged-procedure and Single-surgery groups (VEINES-Sym mean variation 29.7 ± 2.1 vs. 29.9 ± 2.7, respectively; P = 0.340 and VEINES-QoL mean variation 5.5 ± 3.4 vs. 4.5 ± 4.3, respectively; P = 0.369). General QoL, however, showed more improvement in the Staged-procedure than the Single-surgery group (EQD5-5L mean increase 0.1678 ± 0.1555 and 0.0785 ± 0.1384, respectively; P = 0.007). When propensity matched, patient subgroups maintained this same differences in QoL results.
Our findings suggest that the both the Staged- and Single-surgery approach for VV surgical treatment incur similar improvement in disease-specific QoL, and that the Staged-approach may impose less of a burden in the patients' recovery.
在巴西的公共卫生系统中，传统手术是治疗静脉曲张（VV）的标准程序。我们旨在比较单次手术或分期手术（最小间隔 30 天）双侧治疗 VV 的患者的临床和生活质量（QoL）结果。
根据机构方案，共有 111 例接受双侧 VV 治疗的患者接受了单次手术或 2 期手术治疗。在治疗前后，使用 VEINES-Sym/QoL 和 EQ5D-5L 评分评估患者的临床症状和生活质量标志物，并比较组间结果。
一般来说，治疗后 QoL 评分有所改善。VV 特定症状和 QoL 方面在分期手术和单次手术组之间同样改善（VEINES-Sym 平均变化 29.7 ± 2.1 与 29.9 ± 2.7，分别；P = 0.340 和 VEINES-QoL 平均变化 5.5 ± 3.4 与 4.5 ± 4.3，分别；P = 0.369）。然而，一般 QoL 在分期手术组中比单次手术组改善更多（EQD5-5L 平均增加 0.1678 ± 0.1555 和 0.0785 ± 0.1384，分别；P = 0.007）。在进行倾向评分匹配后，患者亚组在 QoL 结果方面仍保持这种差异。
我们的发现表明，VV 手术治疗的分期手术和单次手术方法都能使疾病特异性 QoL 得到相似的改善，而分期手术方法可能对患者的恢复造成的负担较小。
