Untimely contacting a phlebologist with the developed varicose veins is the main reason that it is too late to influence the ailment with ointment or gel.The doctor has to prescribe more effective treatment, among which the operation on varicose veins on the legs is most effective.We should not forget that even the operational removal of a vessel affected by the disease does not guarantee a complete cure - the disease can spread to healthy tissues.
Varicose expansion, or varicose veins is a disease that is characterized by weakness of valves in the veins and dysfunction of the vascular wall, as well as stagnation of blood in the veins of the lower extremities.This pathology is fraught not only with a violation of trophism, or fabric nutrition, a result of which can be difficult and long -term healing trophic ulcers, but also dangerous in that stagnant blood thickens and bloodlines are formed that can be carried by blood flow throughout the body.In addition, in the case of the formation of thrombotic impositions inside the vascular wall (phlebotrombosis), its infection with the development of formidable diseases is possible - thrombophlebitis.
Varicose disease surgery
The operation for varicose veins of the lower extremities is radical and consists in removing the subcutaneous veins of the lower extremities (phlebectomy) or in the sclerosis of the deep veins of the lower leg and hip.
Traditionally, phlebectomy (crossectomy) is performed according to the Bebcock method and consists in introducing the probe into the lumen of the vein with the subsequent stretch of the vein completely over its length through the cut on the skin outside.The incision is sutured at the end of the operation with a cosmetic seam.
Mini-phlebectomy is used to remove very short sections of the vein, during the operation, veins are not used.Cuts on the skin are not carried out, and a piece of vein is removed through a thin puncture on the skin that does not require imposing seams.
With a small area of damage to varicose veins, it is possible to perform a more gentle technique - stripping.This is stretching out with a thin hook of only a varicose node.Experience is carried out by means of two cuts on the skin with their subsequent suturing.A variety of this technique is cryostropping - “sinking” of the vein to the cryosonda using low temperatures, the destructive node is also stretched out.
Vienna sclerosion is the introduction of a sclerosant into its lumen - a substance that “glues” the walls of the vein with each other, but the vein remains deep under the skin, not performing its functions.The blood flow through the vein stops and goes through collateral vessels, without violating the outflow of venous blood from the lower limb.Vienna sclerosis is carried out under the control of ultrasound.
Laser endovascular coagulation of varicose veins is the latest method in phlebology and consists in introducing a thin probe into the lumen of vein with laser radiation, which exerts a cauterizing effect on the walls of the vein.
The method of radio frequency expounding of the veins also refers to a more modern treatment of varicose veins, but not all medical institutions are equipped with appropriate equipment.The technique consists in the “cauterizing” effect on the vascular wall of the radio waves of high frequency.
Indications for the removal of veins
Not all patients are shown surgery, but in some cases it is still impossible to do without it, since it is better to remove the source of potential inflammation and blood clots than to expect complications.States requiring surgical intervention include the following:
- The risk of occurrence or the already arising thrombophlebitis,
- Frequent exacerbations of thrombophlebitis,
- Vast damage to the subcutaneous veins,
- Severe symptoms of varicose veins - a constant feeling of severity and pain in the legs,
- Non -healing trophic ulcers,
- Disorders of the nutrition (trophic) of tissues of the lower extremities - changes in color and cooling of the skin of the legs and feet.
Contraindications to the operation
Carrying out even minimal vascular intervention is contraindicated in the following cases:
- Pregnancy 11 and 111 trimester,
- Acute infectious diseases,
- Exacerbations of chronic diseases (bronchial asthma, diabetes mellitus, stomach ulcer, etc.),
- Acute stroke,
- Acute myocardial infarction,
- Elevated inflammation of the lower extremities.
In any case, all indications and contraindications are determined by a phlebologist or surgeon in the process of full -time examination of the patient.
Which method to choose?
The use of a particular treatment method is evaluated only by a doctor, based on the degree of propagation of the process.
Of course, with small nodes, less invasive methods are preferable, such as mini-phlebectomy, short stripping, laser sprinkling and sclerosis, due to the fact that they are less traumatic and practically do not require a rehabilitation period.At the same time, with a large length of varicose veins, preference is given to traditional phlebectomy, which not only requires spinal anesthesia, but is also a rather traumatic operation, leaving an aesthetic defect in the form of postoperative scrames on the legs.
In this regard, you should not postpone a visit to the doctor at the existing initial stage of varicose veins, and even more so, you do not need to abandon a less traumatic operation if the doctor saw the need for this upon examination.
When is it better to do the operation?
The decision on the need for surgical treatment is made only after consulting a phlebologist or vascular surgeon.Nevertheless, at an early stage when the patient is concerned only to aesthetic discomfort in the form of varicose nodes, as well as a slight swelling of the feet at the end of the day, you can try to stop further progression of the process using compression knitwear and venotonic drugs.
In the case when there is pain in the limbs, as well as the risk of complications, it is not recommended to delay the operation.
Preparation for the operation
Before planning an operation to remove veins, the patient should carry out a number of necessary examinations.These include a consultation of a surgeon or phlebologist, as well as an ultrasound of the veins of the lower extremities.In the case when the patient is shown by the removal of veins, it is examined at the outpatient stage, in particular, general and biochemical blood tests, blood test for coagulation (INC, ACTS, etc.), ECG and radiography of the chest organs should be performed.
On the day prescribed by a doctor, the patient must come to a medical institution practicing phlebectomy.You can independently shake your hair on the lower leg, thigh and in the inguinal zone on the side of the affected limb.The day before, you should limit yourself to a slight dinner, on the operation it is necessary to come on an empty stomach.The patient must warn the operating doctor and an anesthetist about the intolerance to previously taken drugs.
How the operation is carried out
After the patient arrives in the clinic and the initial inspection by the operating surgeon and anesthetist, the issue of anesthesia is resolved.In the case of conventional phlebectomy, spinal anesthesia is used, with mini-operations, local anesthesia is used by choking the skin with novocaine or lidocaine solutions.
After the occurrence of anesthesia, the surgeon establishes the location of the vein using ultrasonic dopplerography (UZDG).Next, through the incision on the skin, the probe is introduced and the main stage of the operation is introduced-the intersection and dressing of vein areas during phlebectomy, stretching the vein with mini-phlebectomy (only through punctures, and not through the incision) or the exposure to the laser on the walls of the vessel.The main stage takes from half an hour to two to three hours, depending on the volume of the operation.
After the main stage, the cuts are sutured on the skin, a pressing aseptic bandage is applied to the wound and the patient is escorted to the ward, where he will be under observation from several hours to a day.In the ward, the patient puts on compression linen, which is not removed for three days.
A day later, the patient goes home.If the surgeon prescribes dressings, the patient visits them daily or every other day.The seams are removed seven days after the operation, and two months later, the UPS of the lower extremities is carried out.
When is the operation is not allowed?
Although the operation to remove veins with varicose veins gives good forecasts and is carried out by effective methods, there are still a number of factors, the presence of which is a contraindication to surgical intervention:
Phlebectomy removal of varicose veins
- Thrombosis of deep veins of the lower extremities.
- When inflammatory processes appear on the legs, including erysipelas and eczema.
- Heart disease and infectious diseases.
- 2nd and 3rd trimester of pregnancy.
- Prolceless age.
Are complications possible after surgery?
The technique of operations, honed to perfection for decades, allows you to minimize the risk of postoperative complications.However, in extremely rare cases (less than 1%), the development of such adverse consequences as:
- Postoperative hematomas on the skin - resolved for a couple of months,
- Postoperative seals under the skin along the bed of a remote vein also disappear a month or two after surgery,
- Mechanical damage to the lymphatic vessels leading to lymphostasis (stagnation of lymph) is treated conservatively, but after a few months the lymph begins to circulate according to anastomosis, and the lymphotot from the limb is carried out properly.
- Damage to the subcutaneous nerves, manifested by transient disorders of skin sensitivity - independently leveled for several months.
Complications and consequences of surgical treatment
No matter how talented a surgeon may be, varicose veins after surgery sometimes again makes itself felt in the form of complications.No one can assume how this or that organism will behave.After surgical intervention on the removal of varicose veins 2 and 3, there may be consequences that do not require treatment - bruises and hematomas, this is a normal reaction of the body to tissue damage.If the patient will follow the recommendations, then everything will pass very quickly.Among other consequences, one can note:
- abundant bleeding;
- a decrease in the sensitivity of the limb (manifests itself with damage to the subcutaneous nerves);
- suppuration when entering infection;
- numbness, etc.
As for pain, they can be observed exclusively with phlebectomy, the other two treatment methods are almost painless.If subsequently there are unpleasant sensations, then they easily stop analgesics.
The consequences can be serious; among the most dangerous, thromboembolia is distinguished.This is an acute clogging of a blood vessel with a thrombus that broke away from the place of its localization and circulates along with the blood stream.If the patient is assisted in a timely manner, then he can become a disabled person and even die.
Forecast and lifestyle after surgery
After the operation, for several days, aching pains in the operated limb and insignificant edema are possible.To stop unpleasant symptoms, the doctor is prescribed non -steroidal drugs - Ketorol, Nise, etc. Immediately after the operation, the patient should begin to wear compression underwear and perform exercises of physiotherapy exercises prescribed by the doctor.
On the second day after the operation, the patient is allowed to walk a little.After a week or two, slow walking should be ensured for a couple of hours a day.
Such provisions as::
- Rejection of bad habits,
- Proper nutrition with the exception of fat and harmful products,
- Compliance with the regime of work and rest,
- The exclusion during working hours of only a sedentary or only standing position - a change in the position of the limbs in the process is necessary.
In conclusion, I would like to note that, judging by the reviews, operations to remove veins are sufficiently favorable, and serious complications practically do not arise.Moreover, the risk of life -threatening complications of varicose veins (thromboembolism, for example) sharply decreases after the removal of an expanded vein.Currently, an amputation of the limb due to severe inflammation and even gangrene due to thrombophlebitis (especially against the background of diabetes) is not rare, so it is better to contact the surgeon at an early stage and not refuse to remove veins if there is a need.Thus, you will keep yourself not only healthy limbs, but also the health of the whole organism as a whole.
Preventive measures
With adverse heredity, when relatives diagnosed varicose veins or a person is at risk for other reasons, it is important to take prevention measures:
Varicose injection
- regularly take vitamin C, which strengthens the walls of blood vessels and improves the characteristics of the composition of the blood;
- use medicines, their intake must be agreed with a doctor;
- use compression linen;
- Physical education is important, swimming, walking on foot, cycling, riding blood flow well.
Prevention also implies a transition to a healthy lifestyle - you need to revise the diet and abandon bad habits.