Varicose veins or varicose veins, these formulas in phlebology, this means a pathology accompanied by modification, that is, deformation of the veins.The veins carrying blood from the heart are stretched, their walls are thin, and the functioning of the venous valves is disturbed.
If the first stage of varicose veins is treated very effectively with conservative methods, then the progression of the disease to the 2nd and 3rd stages can be treated only surgically;Medicines and other methods can only stop the progression of the pathology.In this article, the treatment of varicose veins, features of their implementation, etc.
Instructions for operation
In the first stage of the development of varicose veins, surgical intervention is very rarely performed due to the lack of need, so indications for surgery are a very important factor.The decision is based on the information obtained during the detailed vascular diagnosis and is made by the patient together with the doctor.
The phlebologist is obliged to talk about the risks and nuances of the proposed operation, the duration and nuances of rehabilitation after the operation, which is subsequently carried out with the patient's consent.
As for indications, surgery for varicose veins is necessary in the following cases:
- Pathological expansion and subsequent deformation of the filtering vessels of the secondary and higher degree of severity.
- Wide forms of varicose veins, the disease is not only subcutaneous, not mainly deep veins, or the deformation of the veins spreads to a very large area of the lower extremities.
- There is a serious circulatory disorder accompanied by worsening blood stasis.
- Severe swelling, pain of high intensity, is accompanied by various external (aesthetic) signs.
- The formation of trophic ulcers in the skin or subcutaneous hematomas due to the integrity of blood vessels;
- The progression of the pathological process until the blockage of venous vessels and the development of an acute form of thrombophlebitis.
- The lack of positive dynamics during conservative treatment, that is, the methods of combating with drugs and other methods are weak.
Restrictions and contraindications for operation
Unfortunately, although severe forms of varicose veins develop and are accompanied by complications and a severe clinical picture, the patient cannot always undergo surgery.
There are a number of contraindications that, although they do not completely exclude the possibility of surgical intervention, force to postpone the operation for a certain period of time:
- Coronary heart disease - in this case, it is necessary to conduct a more comprehensive examination.
- The same applies to hypertension of the 3rd degree.
- Active infectious and inflammatory processes in the body - before surgery to treat varicose veins, it is necessary to overcome the infection or eliminate inflammation.
- 2nd and 3rd trimesters of pregnancy - for pregnant women, it is better to postpone any surgical procedure until the woman gives birth.The only exceptions are when there is a serious threat to the life of the mother or the child and can operate.
- Skin disease in the fight against varicose veins.Eczema, various forms of dermatosis, etc.We talk about.
- Of course, there are certain age restrictions associated with older people.In some cases, old age, as well as diseases accompanying old age, increase the risk of developing operative complications or threaten the life of a person on the operating table.
Methods of surgical intervention for varicose veins
However, if the doctor is convinced of the need for surgical intervention after the diagnosis and examination of the patient, all that remains is to choose the most suitable and effective method depending on the degree of development of varicose veins and a number of other factors.We will consider the most effective methods of surgical treatment of varicose veins to understand what operations are there and in what cases they are performed.
Combined phlebectomy
A full-fledged operation that is performed under general anesthesia and can last up to 2 hours, depending on the complexity of the task.Phlebectomy can be used to treat early forms of varicose veins, but this method is used in advanced cases when the disease has progressed seriously.
During the operation, the surgeon makes an incision up to 5 centimeters long or up to 5 centimeters long when working in the ankle area or a larger area, for example, in the groin.Often, these incisions are shallow because mostly superficial veins are removed.
The principle of operation is to close the anastomosis of the vessel and then remove the part of the vessel affected by varicose veins.Also, during the operation, the surgeon can adjust the venous valves to restore normal blood flow.
After the operation is completed, cosmetic sutures are placed on the incisions, bandages are applied, and an elastic bandage is applied to the operated area to prevent bleeding.
Miniphlebectomy
During this procedure, the affected area of the vein is also excised, but the scale of the operation is smaller and can be considered cosmetic in most cases.The idea is that the doctor makes a small puncture in the skin, through which the part of the vein that needs to be cut is removed.This operation is mainly performed in small vessels and its advantages include painlessness (due to local anesthesia) and minimal recovery period.
Sclerotherapy
It is a relatively new technique, famous for its effectiveness, as well as the absence of pain due to the same local anesthesia and a practically non-existent rehabilitation period.
The procedure includes the application of a special substance - a foam sclerosant - into the lumen of the body.This substance causes the vessel to collapse with subsequent adhesions to the walls.As a result, the vessel stops participating in the blood circulation process, gradually dissolves and is replaced by connective tissue.
Sclerotherapy technique is mainly used to eliminate small superficial veins, as well as to get rid of "spider veins".
Laser coagulation
The most modern and, according to many experts, an effective way against varicose veins.Its essence is the introduction of a laser light guide into the venous lumen through a hole of only 2 millimeters.When the latter is activated, it emits laser waves, heats the inside of the vessel, and when the laser is removed, the walls of the vessel collapse and stick together.Later, the vessel disappears by itself and is replaced by connective tissue.
Of course, the main advantage of this procedure is the almost complete absence of visible damage to the skin, as well as the lack of a rehabilitation period.
Possible outcomes
Even the most subtle operation leaves certain traces and can cause consequences.First of all, it is related to the removal of an anatomical component of the body - a full-fledged vessel.Of course, with combined phlebectomy, such consequences can be more serious than a few bruises after laser coagulation.
Let's consider the most basic results that occur from time to time after one or another type of surgical treatment:
- When removing varicose veins, using minimally invasive methods that exclude the removal of the vein, there is a risk of relapse.This risk is minimal during laser coagulation, only 5%.
- Burns - occurs after operations in which thermal effects are used.
- Bleeding - can start after any intervention, but is more likely after phlebectomy.
- There are also cases of nerve damage, but this factor is only related to the level of professionalism of the surgeon.
Rehabilitation process
Rehabilitation, that is, recovery after surgery, is required in each of the cases described, but if this process takes only a few days after clotting, it can last several weeks.It is important to follow simple recommendations to ensure a smooth and quick recovery:
- Follow all your doctor's advice strictly.
- Wear compression garments or elastic bandages.
- If there were cuts, it is important to wait for them to heal.
- After the incisions have healed, it is important to resume physical activity;Therapy and regular walks will help with this.
- If your doctor prescribes any medications, take them as directed.
- It is also useful to visit a massage therapist after surgery and prevent varicose veins.
- You should not expose yourself to serious physical activity for at least 2-3 months.
The operation went well, and if the patient fully follows all the instructions of all doctors regarding recovery, the probability of a favorable outcome is very high.In most cases, varicose veins can be treated, but this does not mean that the disease cannot affect other vessels.For this reason, if there were cases of the development of this pathology, prevention of varicose veins should always be carried out.