Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202102021
Jornal Vascular Brasileiro
Original Article

Perfil epidemiológico do tratamento cirúrgico de varizes no Brasil no período de 2010 a 2020

Epidemiological profile of surgical treatment of varicose veins in Brazil from 2010 to 2020

Lívia Guerreiro de Barros Bentes; Rafael Silva Lemos; Deivid Ramos dos Santos; José Maciel Caldas dos Reis

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Resumo

Resumo: Contexto: As varizes são um agravo que vêm aumentando nos últimos anos e, nos casos mais graves, necessitam de tratamento cirúrgico para a resolução do quadro clínico do paciente. Apesar da sua importância, não há trabalhos epidemiológicos que englobem todo o território brasileiro de modo a demonstrar como está a distribuição das cirurgias para a correção desse agravo pelo Sistema Único de Saúde.

Objetivos: Descrever o perfil ecológico do tratamento cirúrgico para a correção de varizes no Brasil no período de 2010 a 2020.

Métodos: O estudo caracteriza-se como descritivo-analítico, mediante a coleta de dados proveniente do Sistema de Informações Hospitalares do Sistema Único de Saúde. Os dados, disponibilizados pela própria plataforma, foram tabelados e categorizados de acordo com o estado, a região, o caráter do procedimento e o ano de realização. O programa BioEstat 5.3 foi utilizado para a realização do teste estatístico de qui-quadrado, sendo adotado o intervalo de confiança de 95% e o valor significativo de p <0,05.

Resultados: No período de 2010 a 2020, foram realizadas 755.752 cirurgias para o tratamento de varizes, sendo 292.538 unilaterais (38,71%) e 463.214 (61,29%) bilaterais. A região Sudeste foi responsável por 418.791 (55,41%) procedimentos, seguida pelo Sul, com 180.689 (23,91%). Foram registradas 40 mortes pelo procedimento no período analisado, das quais 26 ocorreram em cirurgias bilaterais (65%) e a maioria no Sudeste (24 óbitos).

Conclusões: Verificou-se que esse procedimento é realizado majoritariamente nas regiões Sudeste e Sul, com maior prevalência da cirurgia bilateral de caráter eletivo.

Palavras-chave

varizes, procedimentos cirúrgicos vasculares, perfil epidemiológico

Abstract

Background: Varicose veins have become more common over recent years and in the most serious cases surgical treatment is necessary to resolve patients’ clinical status. Despite their importance, there are no epidemiological studies that cover the whole of Brazil, showing how surgery to correct varicose veins conducted by the Unified Health System (SUS) is distributed in the country. Objectives: To describe the ecological profile of surgical treatment to correct varicose veins in Brazil from 2010 to 2020. Methods: This is a descriptive-analytical study of data obtained from the SUS Hospital Information System. These data were tabulated and categorized by state, region, type of procedure, and year. BioEstat 5.3 was used to conduct chi-square statistical tests with a 95% confidence interval and significance cutoff of p <0.05. Results: From 2010 to 2020, 755,752 surgical operations to treat varicose veins were conducted; 292,538 were unilateral (38.71%) and 463,214 (61.29%) were bilateral. Of these, 418,791 (55.41%) procedures were performed in the Southeast region, followed by 180,689 (23.91%) in the South region. A total of 40 deaths were registered in connection with these procedures during the period, 26 of which (65%) were associated with bilateral surgery and the majority of which occurred in the Southeast (24 deaths). Conclusions: It was observed that the majority of procedures are performed in the Southeast and South regions, and that bilateral elective surgery is the most prevalent.

Keywords

varicose veins; surgical procedures vascular; epidemiological profile.

References

1 Lins EM, Barros JW, Appolônio F, Lima EC, Barbosa M Jr, Anacleto E. Perfil epidemiológico de pacientes submetidos a tratamento cirúrgico de varizes de membros inferiores. J Vasc Bras. 2012;11(4):301-4. http://dx.doi.org/10.1590/S1677-54492012000400008.

2 Jacobs BN, Andraska EA, Obi AT, Wakefield TW. Pathophysiology of varicose veins. J Vasc Surg. 2017;5(3):460-7. http://dx.doi.org/10.1016/j.jvsv.2016.12.014. PMid:28411716.

3 DePopas E, Brown M. Varicose Veins and Lower Extremity Venous Insufficienc. Semin Intervent Radiol. 2018;35(1):56-61. http://dx.doi.org/10.1055/s-0038-1636522. PMid:29628617.

4 Raetz J, Wilson M, Collins K. Varicose veins: diagnosis and treatment. Am Fam Physician. 2019;99(11):682-8. PMid:31150188.

5 Wu N, Chen Z, Feng I, et al. Severe varicose veins and the risk of mortality: a nationwide population-based cohort study. BMJ Open. 2020;10(6):e034245. http://dx.doi.org/10.1136/bmjopen-2019-034245. PMid:32565451.

6 Serra R, Ielapi N, Bevacqua E, et al. Haemorrhage from varicose veins and varicose ulceration: a systematic review. Int Wound J. 2018;15(5):829-33. http://dx.doi.org/10.1111/iwj.12934. PMid:29808553.

7 Belramman A, Bootun R, Lane TRA, Davies AH. Endovenous management of varicose veins. Angiology. 2019;70(5):388-96. http://dx.doi.org/10.1177/0003319718780049. PMid:29874921.

8 Rocha FA, Lins EM, de Almeida CC, et al. Quality of life assessment before and after surgery for lower limb varicose veins. J Vasc Bras. 2020;19:e20190108. http://dx.doi.org/10.1590/1677-5449.190108. PMid:34178063.

9 Geersen DF, Shortell CEK. Phlebectomy techniques for varicose veins. Surg Clin North Am. 2018;98(2):401-14. http://dx.doi.org/10.1016/j.suc.2017.11.008. PMid:29502780.

10 Barros BCS, Araujo AL, Magalhães CEV, Barros RLS, Fiorelli SKA, Gatts RF. Efficacy of varicose vein surgery with preservation of the great safenous vein. Rev Col Bras Cir. 2015;42(2):111-5. http://dx.doi.org/10.1590/0100-69912015002008. PMid:26176677.

11 Reis JMC, Santos DR, Torres IO, De Luccia N. Vascular surgery in the most populous state in Amazon: socio-professional profile and aspirations of the speciality. J Vasc Bras. 2021;20:e20210039. https://doi.org/10.1590/1677-5449.210039.

12 Campoy LT, Ramos ACV, Souza LLL, et al. A distribuição espacial e a tendência temporal de recursos humanos para o Sistema Único de Saúde e para a Saúde Suplementar, Brasil, 2005 a 2016. Epidemiol Serv Saude. 2020;29(2):e2018376. http://dx.doi.org/10.5123/S1679-49742020000200020. PMid:32401878.

13 DATASUS [site na Internet]. Brasília, DF: Ministério da Saúde; 2021. [citado 2021 set 30]. https://datasus.saude.gov.br.

14 Abraão LSO, José BMPA, Gomes CBS, et al. Perfil epidemiológico dos casos de leishmaniose tegumentar americana no estado do Pará, Brasil, entre 2008 e 2017. Rev Pan-Amaz Saude. 2020;11:e202000612. http://dx.doi.org/10.5123/S2176-6223202000612.

15 da Silva AFT, Valente FS, de Sousa LD, Cardoso PNM, da Silva MA, dos Santos DR. Estudo epidemiológico sobre meningite bacteriana no Brasil no período entre 2009 a 2018. Rev Med (São Paulo). 2021;100(3):220-8. http://dx.doi.org/10.11606/issn.1679-9836.v100i3p220-228.

16 Guedes BAP, Vale FLB, Souza RW, Costa MKA, Batista SR. A organização da atenção ambulatorial secundária na SESDF. Ciênc Saúde Colet. 2019;24(6):2125-34. http://dx.doi.org/10.1590/1413-81232018246.08632019.

17 Scheffer M, coordenador. Demografia Médica no Brasil 2020. São Paulo (SP): FMUSP-CFM; 2020.

18 Defty C, Eardley N, Taylor M, Jones DR, Mason PF. A comparison of the complication rates following unilateral and bilateral varicose vein surgery. Eur J Vasc Endovasc Surg. 2008;35(6):745-9. http://dx.doi.org/10.1016/j.ejvs.2008.01.009. PMid:18343168.

19 Pereira AFB, Mesquita A, Gomes C. Abordagens cirúrgicas no tratamento de varizes. Angiol Cir Vasc. 2014;10(3):132-40. http://dx.doi.org/10.1016/j.ancv.2014.08.003.

20 Belramman A, Bootun R, Lane TRA, Davies AH. Foam sclerotherapy versus ambulatory phlebectomy for the treatment of varicose vein tributaries: study protocol for a randomised controlled trial. J Ayub Med Coll Abbottabad. 2019;20:392. https://doi.org/10.1186/s13063-019-3398-0.

21 Epstein D, Onida S, Bootun R, Ortega-Ortega M, Davies AH. Cost-effectiveness of current and emerging treatments of varicoseveins. Value Health. 2018;21(8):911-20. http://dx.doi.org/10.1016/j.jval.2018.01.012. PMid:30098668.

22 Kharl RAK, Khan NI, Pervaiz HK, et al. Foam clerotherapy: an emerging, minimally invasive and safe modality of treatment for varicose veins. J Ayub Med Coll Abbottabad. 2019;31(4, Suppl 1):641-5.

23 Rasmussen L, Lawaetz M, Serup J, et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous Lymphat Disord. 2013;1(4):349-56. http://dx.doi.org/10.1016/j.jvsv.2013.04.008. PMid:26992754.

24 Venermo M, Saarinen J, Eskelinen E, et al. Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy for the treatment of great saphenous varicose veins. Br J Surg. 2016;103(11):1438-44. http://dx.doi.org/10.1002/bjs.10260. PMid:27561823.

25 Diaz A, Sarac BA, Schoenbrunner AR, Janis JE, Pawlik TM. Elective surgery in the time of COVID-19. Am J Surg. 2020;219(6):900-2. http://dx.doi.org/10.1016/j.amjsurg.2020.04.014. PMid:32312477.

26 Motta GR Fo, Leal AC, Amaral MVG, Maia PAV, Duarte MEL, Bähr GL. Impacto das estratégias adotadas para enfrentar a pandemia de COVID-19 em um Instituto Brasileiro de referência em cirurgia de alta complexidade em Ortopedia e Traumatologia. Rev Bras Ortop. 2021;56(2):161-7. http://dx.doi.org/10.1055/s-0041-1728703.

27 Krasinski Z, Krasinska A, Markiewicz S, Zielinski M. Patients with chronic venous insufficiency in the times of COVID-19 and the risk of thrombus formation - suggestions on conservative treatment of such patients based on the principles of pathophysiology. Pol Przegl Chir. 2021;93(2):43-52. http://dx.doi.org/10.5604/01.3001.0014.8500. PMid:33949321.

28 Bootun R, Davies AH. Long-term follow-up for different varicose vein therapies: is surgery still the best? Phlebology. 2016;31(1, Suppl):125-9. http://dx.doi.org/10.1177/0268355516632438. PMid:26916779.

29 Kim TI, Zhang Y, Guzman RJ, Ochoa Chaar CI. Trends of hospital-based surgery for varicose veins in elderly. J Vasc Surg Venous Lymphat Disord. 2021;9(1):146-53.e2. http://dx.doi.org/10.1016/j.jvsv.2020.04.016. PMid:32360785.

30 Silva MJ, Louzada ACS, Silva MFA, Portugal MFC, Teivelis MP, Wolosker N. Epidemiology of 869,220 varicose vein surgeries over 12 years in Brazil: trends, costs and mortality rate. Ann Vasc Surg. 2022;82:1-6. https://doi.org/10.1016/j.avsg.2021.11.016.

31 Sant’Ana SM, Bachion MM, Santos QR, Nunes CABN, Malaquias SG, Oliveira BGRB. Úlceras venosas: caracterização clínica e tratamento em usuários atendidos em rede ambulatorial. Rev Bras Enferm. 2012;65(4):637-44. http://dx.doi.org/10.1590/S0034-71672012000400013. PMid:23258684.
 


Submitted date:
11/24/2021

Accepted date:
07/28/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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