Abstract
Background
Surgical treatment of medically uncomplicated varicose veins is common, but its clinical effectiveness remains uncertain.
Methods
A randomized clinical trial was carried out at two large acute National Health Service hospitals in different parts of the UK (Sheffield and Exeter). Some 246 patients were recruited from 536 consecutive referrals to vascular outpatient clinics with uncomplicated varicose veins suitable for surgical treatment. Conservative management, consisting of lifestyle advice, was compared with surgical treatment (flush ligation of sites of reflux, stripping of the long saphenous vein and multiple phlebectomies, as appropriate). Changes in health status were measured using the Short Form (SF) 6D and EuroQol (EQ) 5D, quality of life instruments based on SF-36 and EuroQol, complications of treatment, symptomatic measures, anatomical extent of varicose veins and patient satisfaction.
Results
In the first 2 years after treatment there was a significant quality of life benefit for surgery of 0ยท083 (95 per cent confidence interval (c.i.) 0ยท005 to 0ยท16) quality-adjusted life years (QALYs) based on the SF-6D score and 0ยท13 (95 per cent c.i. 0ยท016 to 0ยท25) based on the EQ-5D score. Significant benefits were also seen in symptomatic and anatomical measures.
Conclusion
Surgical treatment provides symptomatic relief and significant improvements in quality of life in patients referred to secondary care with uncomplicated varicose veins.