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Vascular Training Does Matter in the Outcomes of Saphenous High Ligation and Stripping

2019Journal article Open access
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dc.contributor.authorCastro-Ferreira, R
dc.contributor.authorQuelhas, MJ
dc.contributor.authorFreitas, A
dc.contributor.authorVidoedo, J
dc.contributor.authorAlves Silva, E
dc.contributor.authorMarinho, A
dc.contributor.authorAbreu, R
dc.contributor.authorCoelho, A
dc.contributor.authorGonçalves Dias, P
dc.contributor.authorMoreira Sampaio, S
dc.date.accessioned2021-03-17T14:46:12Z
dc.date.available2021-03-17T14:46:12Z
dc.date.issued2019
dc.description.abstractObjective: Varicose vein (VV) surgery is frequently performed by surgeons without formal vascular training. We aimed to compare the outcomes of the procedure based on the background of the surgeon. Methods: All patients registered with VV surgery between 2004 and 2016 in Portuguese public hospitals were included in the study. Intrahospital outcomes were assessed from this administrative database. A random multicenter sample of 315 patients submitted to saphenous high ligation and stripping (175 patients from six vascular surgery departments and 140 patients from five general surgery divisions) were further queried over the phone, whereby additional nonregistered outcomes were evaluated: preoperative venous ultrasound, impact on quality of life by the 14-item Chronic Venous Insufficiency Quality of Life Questionnaire, visual analogue scale evaluation (score of 1 to 5) of the aesthetic results and general satisfaction, work absence days, and time to return to physical activities. Results: In 13 years, there were 153,382 patients submitted to VV surgery. Of these, 49% were operated on by general surgeons and 40% by vascular surgeons; in 11%, it was not possible to identify the specialty performing the operation. Twenty-three deaths were registered (no differences between groups). In the general surgery group, 14% of patients were hospitalized for more than one night compared with 3% in the vascular group (P < .001). Reintervention rate during the period analyzed was significantly higher in the general surgery group (13.5% vs 8.2%; P < .001). Rate of outpatient surgery was higher in the vascular surgery group (60% vs 36%; P < .001). Phone query revealed similar overall satisfaction and improvement in quality of life in both groups (4.2 vs 4.0 [P = .275] and 35% vs 36% [P = .745], respectively). However, patients operated on by general surgeons reported worse surgical scars (2.8 vs 2.1; P = .007), higher number of residual VVs (2.4 vs 1.7; P = .006), and higher number of days absent from work (40 vs 27 days; P = .005) and took longer to resume physical activities (60 vs 41 days; P = .001). Conclusions: Despite that the majority of VV surgery in Portugal is executed by general surgeons, this study highlights important advantages when it is performed by surgeons with vascular training.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Vasc Surg Venous Lymphat Disord. 2019 Sep;7(5):732-738.pt_PT
dc.identifier.doi10.1016/j.jvsv.2019.01.060pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3592
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAbsenteeismpt_PT
dc.subjectAdultpt_PT
dc.subjectDatabases, Factualpt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectLigationpt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPatient Satisfactionpt_PT
dc.subjectPortugalpt_PT
dc.subjectQuality of Lifept_PT
dc.subjectRecovery of Functionpt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectReturn to Sportpt_PT
dc.subjectReturn to Workpt_PT
dc.subjectSaphenous Veinpt_PT
dc.subjectSurgeonspt_PT
dc.subjectTime Factorspt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectVaricose Veinspt_PT
dc.subjectVascular Surgical Procedurespt_PT
dc.subjectEducation, Medical, Graduatept_PT
dc.subjectSpecializationpt_PT
dc.subjectHSM CIR VASCpt_PT
dc.titleVascular Training Does Matter in the Outcomes of Saphenous High Ligation and Strippingpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage738pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage732pt_PT
oaire.citation.titleJournal of Vascular Surgery. Venous and Lymphatic Disorderspt_PT
oaire.citation.volume7pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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