The effectiveness of various interventions versus standard stripping in patients with varicose veins in terms of quality of life

被引:14
作者
Argyriou, Christos [1 ]
Papasideris, Christos [2 ]
Antoniou, George A. [3 ]
Georgakarakos, Efstratios [1 ]
Papanas, Nikolaos [4 ]
Lazarides, Miltos K. [1 ]
Georgiadis, George S. [1 ]
机构
[1] Democritus Univ Thrace, Univ Gen Hosp Evros, Dept Vasc Surg, Alexandroupolis, Greece
[2] Univ Athens, Attikon Univ Hosp, Dept Vasc Surg, Athens, Greece
[3] Pennine Acute Hosp NHS Trust, Royal Oldham Hosp, Dept Vasc & Endovasc Surg, Manchester, Lancs, England
[4] Democritus Univ Thrace, Univ Gen Hosp Evros, Dept Internal Med 2, Alexandroupolis, Greece
关键词
Quality of life; endovenous techniques; varicose veins; vein stripping; randomized trial; meta-analysis; ENDOVENOUS LASER-ABLATION; RANDOMIZED CLINICAL-TRIAL; GREAT SAPHENOUS-VEIN; CHRONIC VENOUS DISORDERS; 2-YEAR FOLLOW-UP; HIGH LIGATION; RADIOFREQUENCY ABLATION; FOAM SCLEROTHERAPY; SURGERY; OUTCOMES;
D O I
10.1177/0268355517720307
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose Lower limb varicose veins have a significant effect upon the quality of life and a considerable socioeconomic impact despite their relatively benign nature. The aim of this study is to compare the effects of various therapeutic strategies among patients with varicose veins to surgical ligation and vein stripping on the basis of quality of life. Methods PubMed/Medline and Scopus databases were systemically searched from 1 January 2000 until 23 December 2015 for studies reporting outcome on the quality of life of different treatment techniques for varicose veins. We used Cohen's d to make the outcomes of the reported scales comparable. Heterogeneity was calculated with the use of the Q statistic and the I-2. Results A total of 1047 participants were randomized across all analyzed trials. The number of participants in a single trial ranged from 30 to 308. The majority of participants in any trial were C2 on the CEAP scores. Overall, the quality of evidence was low. For the meta-analysis performed at 12 months postintervention (seven studies, n=1047 patients) and after random effects meta-analyses due to high heterogeneity, no differences are observed between intervention and surgical ligation and vein stripping. The pooled estimate is -0.001 and the 95% confidence interval is -0.069 to 0.067 with a p=0.98. In the case of the 24 months, postintervention analysis (six studies, n=840 patients) the inference is almost identical. The effect of various interventional modes of treatment compared to surgical ligation and vein stripping is negligible in terms of clinical outcomes and quality of life so that surgical ligation and vein stripping versus the other interventional procedures were equally effective approaches to treat great saphenous vein incompetence in terms of quality of life measurements. Conclusion The procedures were at least equally efficient in treating patients with varicose vein disease in terms of quality of life assessment tools at 12 and 24 months compared to surgical ligation and vein stripping.
引用
收藏
页码:439 / 450
页数:12
相关论文
共 48 条
[1]  
[Anonymous], ULTR GUID FOAM SCLER
[2]   A comparison of health-related quality of life of patients with primary and recurrent varicose veins [J].
Beresford, T ;
Smith, JJ ;
Brown, L ;
Greenhalgh, RM ;
Davies, AH .
PHLEBOLOGY, 2003, 18 (01) :35-37
[3]   THE EPIDEMIOLOGY OF VARICOSE-VEINS - THE FRAMINGHAM-STUDY [J].
BRAND, FN ;
DANNENBERG, AL ;
ABBOTT, RD ;
KANNEL, WB .
AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 1988, 4 (02) :96-101
[4]   Comparing the treatment response of great saphenous and small saphenous vein incompetence following surgery and endovenous laser ablation: a retrospective cohort study [J].
Carradice, D. ;
Samuel, N. ;
Wallace, T. ;
Mazari, F. A. K. ;
Hatfield, J. ;
Chetter, I. .
PHLEBOLOGY, 2012, 27 (03) :128-134
[5]   Systematic review, network meta-analysis and exploratory cost-effectiveness model of randomized trials of minimally invasive techniques versus surgery for varicose veins [J].
Carroll, C. ;
Hummel, S. ;
Leaviss, J. ;
Ren, S. ;
Stevens, J. W. ;
Cantrell, A. ;
Michaels, J. .
BRITISH JOURNAL OF SURGERY, 2014, 101 (09) :1040-1052
[6]   Prospective randomized trial comparing endovenous laser ablation and surgery for treatment of primary great saphenous varicose veins with a 2-year follow-up [J].
Christenson, Jan T. ;
Gueddi, Salah ;
Gemayel, Gino ;
Bounameaux, Henri .
JOURNAL OF VASCULAR SURGERY, 2010, 52 (05) :1234-1241
[7]   Generic Health-related Quality of Life is Significantly Worse in Varicose Vein Patients with Lower Limb Symptoms Independent of Ceap Clinical Grade [J].
Darvall, K. A. L. ;
Bate, G. R. ;
Adam, D. J. ;
Bradbury, A. W. .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2012, 44 (03) :341-344
[8]   Randomised Comparison of Costs and Cost-Effectiveness of Cryostripping and Endovenous Laser Ablation for Varicose Veins: 2-Year Results [J].
Disselhoff, B. C. V. M. ;
Buskens, E. ;
Kelder, J. C. ;
Kinderen, D. J. der ;
Moll, F. L. .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2009, 37 (03) :357-363
[9]   Revision of the CEAP classification for chronic venous disorders:: Consensus statement [J].
Eklöf, B ;
Rutherford, RB ;
Bergan, JJ ;
Carpentier, PH ;
Gloviczki, P ;
Kistner, RL ;
Meissner, MH ;
Moneta, GL ;
Myers, K ;
Padberg, FT ;
Perrin, M ;
Ruckley, CV ;
Smith, PC ;
Wakefield, TW .
JOURNAL OF VASCULAR SURGERY, 2004, 40 (06) :1248-1252
[10]   Clinical outcomes and quality of life 5 years after a randomized trial of concomitant or sequential phlebectomy following endovenous laser ablation for varicose veins [J].
El-Sheikha, J. ;
Nandhra, S. ;
Carradice, D. ;
Wallace, T. ;
Samuel, N. ;
Smith, G. E. ;
Chetter, I. C. .
BRITISH JOURNAL OF SURGERY, 2014, 101 (09) :1093-1097