Surgical treatment of varicose veins of the lower extremities and the current comorbid background

Introduction . Varicose veins of the lower extremities are a common pathology affecting about 25–33% of the adult population. The treatment of this disease requires studying the influence of comorbidities on the choice of surgical treatment tactics for varicose veins. Aim . To assess the degree of influence of comorbid conditions on decision-making regarding the method of surgical intervention and to develop an algorithm for a personalized treatment approach. Materials and methods . A retrospective analysis of 500 medical records of patients who underwent surgical treatment for varicose veins was conducted using multivariate statistical analysis and machine learning methods to identify significant correlations. To assess long-term results, a prospective observation of 100 patients was additionally conducted for one year after surgery. Results. The results of the study showed that the presence of cardiovascular diseases increases the risk of postoperative complications by 23%, which requires correction of surgical tactics. A significant association between diabetes mellitus and increased duration of postoperative wound healing was revealed (p < 0.01). The analysis of long-term results showed that patients with comorbidities have a higher risk of varicose vein recurrence, especially in the presence of obesity and diabetes mellitus. Discussion . The results demonstrate the necessity of differentiated approach to the choice of surgical tactics taking into account the individual profile of the patient’s comorbidity. Conclusions . The developed prognostic algorithm and the proposed recommendations can serve as a basis for the creation of clinical guidelines aimed at improving the efficacy and safety of surgical treatment of varicose veins in patients with comorbidities.