State University of Medicine and Pharmacy «Nicolae Testemitanu»,
Chisinau, Republic of Moldova
Since the rate of recurrence and grade of clinical improvement
after varicose veins treatment by endovenous ablation or conventional surgery
are comparable, selection of intervention type and strategy are often
based on surgeon preferences. We hypothesize that patient involvement in
decision making may increase his/her satisfaction by results of treatment.
Methods. One hundred patients with C2-3EpAsPr varicose
veins were enrolled. The exact curative strategy was planed prior to intervention
in each patient, regarding to method of saphenous reflux treatment
(stripping or endovenous laser ablation or foam sclerotherapy) and
timing of flebectomy (concomitant or deferred). Patients were randomly
allocated to one of two groups. In group A – decision regarding optimal
curative strategy was done by a specialist. In group B the treatment
type was selected by patient itself, basing on provided evidence-based
information. Patient satisfaction by treatment was assessed 6 months after intervention using dichotomous end-point (satisfied or unsatisfied) and visual analogues score.
Results. Major postoperative complications were not registered
in both groups. There were more patients satisfied by treatment of
varicose veins in group B – 98% vs 92% in group A, although the Z-test
for proportion shows not-significance. The mean grade of patient satisfaction,
assessed by visual analogues score, was higher in group B – 8,08 vs
7,58 in group A (P = 0.0446 according to Mann-Whitney test).
Conclusion. Patient participation in decision making during
planning of interventions for varicose veins may contribute to improvement
of patient related-related treatment outcomes. The complete and reliable
information regarding the advantages and disadvantages of different
surgical techniques and approaches should be provided to the patient
preoperatively.