LIFE QUALITY DYNAMICS OF PATIENTS AFTER ENDOVENOUS LASER OBLITERATION AND COMBINED PHLEBECTOMY

Aim. To analyze the life quality of patients with varicose veins of lower limbs (VVLL) during hospital and longterm observation after endovenous laser obliteration (EVLO) and combinedphlebectomy (CF). Material and method. This prospective study included 408 patients with varicose veins of lower limbs who underwent surgery for the period from 2013 - 2017. Based on treatment strategy, patients were divided into two groups: the first group included 257 (63%) patients that underwent EVLO; patients of the second group included patients that underwent CF in the number of 151 (37%) patients. At the preoperative stage, the spectrum of clinical manifestations of CVI was determined based on the clinical, etiological, anatomical and pathophysiological classification system (CEAP). To assess the life quality, two types of scales were used: Chronic Venous Disease quality of life Questionnaires (CIVIQ) and SF-36 Health Status Survey. Results and discussion. 2 years after the treatment, according to the CIVIQ scale, statistically significant life quality dynamics using both treatment tactics were observed. Comparison of the indicators two years after the treatment revealed a statistically significant difference (p = 0.008) due to the presence of the phenomenon of recanalization (relapse) according to ultrasound and a partial return of CVI symptoms in patients of the CF group. A comparison of the survey results between groups according to the SF-36 scale in 2 years after the treatment showed significant differences. tTe EVLO group showed higher levels of life quality in most indicators. Conclusion. Thus, both treatment strategies statistically significantly increased the life quality of patients in the long-term postoperative follow-up period. However, EVLO showed greater effectiveness in the dynamics of this indicator in comparison to CF, which was most likely due to the presence of recanalization in every second patient of the second group after two years of observation.

chronic venous insufficiency of the lower extremities, endovenous laser obliteration, combined phlebectomy, hospital period, long-term period, quality of life

1. Гаибов А.Д. Важнейшие аспекты диагностики и лечения острого варикотромбофлебита / А.Д. Гаибов, О.Н. Садриев, Э.С. Джуракулов, Д.Д. Султанов // Вестник Авиценны. - 2016. - №3 (68). - С. 95-103.

2. Davies A.H. The Seriousness of Chronic Venous Disease: A Review of Real-World Evidence. Advances in Therapy, 2019. doi: 10.1007/s12325-019-0881-7.

3. Eberhardt R.T., Raffetto J. D. Chronic venous insufficiency. Circulation, 2014, Vol. 130, pp. 333- 346. doi: 10.1161/CIRCULATIONAHA.113.006898.

4. Mansilha A, Sousa J. Pathophysiological Mechanisms of Chronic Venous Disease and Implications for Venoactive Drug Therapy. International Journal of Molecular Sciences, 2018, No. 5, Vol. 19(6). doi: 10.3390/ijms19061669.

5. Imbernon-Moya A., Ortiz-de Frutos F.J., San-juan-Alvarez M., Portero-Sanchez I., Merinero-Pal-omares R., Alcazar V. Pain and analgesic drugs in chronic venous ulcers with topical sevoflurane use. Journal of Vascular Surgery, 2018. doi:10.1016/j. jvs.2017.11.071.

6. Rabe E., Guex J.J., Puskas A., Scuderi A., Fernandez Quesada F. Epidemiology of chronic venous disorders in geographically diverse populations: Results from the Vein Consult Program. International Angiology, 2012, Vol. 31, pp. 105-115.