Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2024 Apr 3;79:100346. doi: 10.1016/j.clinsp.2024.100346. eCollection 2024.
Lower limb varicose veins are a prevalent disease associated with several available treatment options, including conventional surgery and polidocanol foam sclerotherapy. However, few studies have analyzed therapeutic modality outcomes based on Patient-Reported Outcome Measures (PROMs). This large sample-size study was designed to evaluate the outcomes of polidocanol foam sclerotherapy compared to conventional surgery based on an analysis of PROMs.
This was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with either polidocanol foam sclerotherapy (57 patients, 90 legs) or conventional surgery (148 patients, 236 legs). Patients were preoperatively assessed and re-evaluated 30 days after the procedure using the Venous Disease Severity Score (VCSS) and specific venous disease quality-of-life questionnaires (VEINES-QoL/Sym).
Both treatments significantly improved VCSS and VEINES results 30 days after the procedure (p < 0.05). However, surgery promoted greater improvements in VCSS (on average 4.02-points improvement, p < 0.001), VEINES-QoL (average 8-points improvement, p < 0.001), and VEINES-Sym (average 11.66 points improvement, p < 0.001) than did sclerotherapy. Postoperative pain and aesthetic concerns about the legs were the domains of the questionnaires in which the results varied the most between the treatment modalities, with worse results for sclerotherapy.
Both polidocanol foam sclerotherapy and conventional surgery positively impact patients' quality of life after 30 days, but the improvement is more significant for patients who undergo conventional surgery.
下肢静脉曲张是一种常见疾病,有多种治疗方法可供选择,包括传统手术和聚多卡醇泡沫硬化疗法。然而,很少有研究根据患者报告的结果测量(PROMs)分析治疗方法的结果。这项大型样本量研究旨在根据 PROMs 分析评估聚多卡醇泡沫硬化疗法与传统手术的治疗效果。
这是一项前瞻性、观察性和定性研究,共纳入 205 例接受静脉曲张治疗的患者,其中 57 例(90 条腿)采用聚多卡醇泡沫硬化疗法,148 例(236 条腿)采用传统手术。患者在术前和术后 30 天使用静脉疾病严重程度评分(VCSS)和特定的静脉疾病生活质量问卷(VEINES-QoL/Sym)进行评估。
两种治疗方法在术后 30 天均显著改善了 VCSS 和 VEINES 结果(p < 0.05)。然而,手术在 VCSS(平均改善 4.02 分,p < 0.001)、VEINES-QoL(平均改善 8 分,p < 0.001)和 VEINES-Sym(平均改善 11.66 分,p < 0.001)方面的改善程度均大于硬化疗法。术后疼痛和腿部美观问题是问卷中结果差异最大的两个领域,硬化疗法的结果较差。
聚多卡醇泡沫硬化疗法和传统手术均能在术后 30 天内显著提高患者的生活质量,但传统手术的改善程度更为明显。