title: Postoperative pain and early quality of life after radiofrequency ablation and mechanochemical endovenous ablation of incompetent great saphenous veins.
abstract: OBJECTIVE
  Thermal ablative techniques of varicose veins carry a risk of heat-related complications, including postoperative pain. Mechanochemical endovenous ablation (MOCA) might avoid these complications and reduce postoperative pain because of the absence of thermal energy. This study evaluated postoperative pain and quality of life after radiofrequency ablation (RFA) and MOCA for great saphenous vein (GSV) incompetence.
  
  
  METHODS
  Sixty-eight patients with unilateral GSV incompetence were treated with either RFA or MOCA in this prospective observational study. Patients monitored their pain for the first 14 postoperative days on a 100-mm visual analog scale (VAS). They also completed the general (RAND 36-Item Short-Form Health Survey) and disease-specific (Aberdeen Varicose Vein Questionnaire) quality of life questionnaires before and 6 weeks after treatment.
  
  
  RESULTS
  Patients treated with MOCA reported significantly less postoperative pain than patients treated with RFA during the first 14 days after treatment (4.8 ± 9.7 mm vs 18.6 ± 17.0 mm; P < .001) (mean VAS over 14 days). The lower postoperative pain score was associated with a significantly earlier return to normal activities (1.2 ± 1.8 vs 2.4 ± 2.8 days; P = .02) and work resumption (3.3 ± 4.7 vs 5.6 ± 5.8 days, respectively; P = .02). At 6 weeks, patients in both groups perceived an improved change in health status and an improved disease-specific quality of life.
  
  
  CONCLUSIONS
  MOCA is associated with significantly less postoperative pain, faster recovery, and earlier work resumption compared with RFA in the treatment of GSV incompetence. MOCA and RFA are both related to a rapid improvement in quality of life.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Ramon R J P
authors.initials: RR
authors.lastname: van Eekeren
authors.forename: Doeke
authors.initials: D
authors.lastname: Boersma
authors.forename: Vincent
authors.initials: V
authors.lastname: Konijn
authors.forename: Jean Paul P M
authors.initials: JP
authors.lastname: de Vries
authors.forename: Michel M J P
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects* / Q000523:psychology; D016009:Chi-Square Distribution; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D012501:Saphenous Vein / Q000503:physiopathology / Q000601:surgery*; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000009:adverse effects* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols