Treatment of varicose veins on the legs with the help of medications does not always has a positive effect. It is especially difficult to cure varicose veins if it is in an advanced stage. In this case, surgical intervention was the only option to eliminate pathology. For many people the operation to be a terrible procedure, so they are a long time afraid to go to the doctor, relying on some forms of home treatment. The disease continues to progress and the patient's condition to deteriorate.
When you need to do?
Surgery for varicose veins of the lower extremities is assigned under the following circumstances:
- if saphenous vein is increased due to physiological pathology;
- if the disease is in an advanced stage, when treatment of varicose veins medicines or folk remedies does not help;
- in the formation of trophic ulcers on the skin;
- if violations occur vascular blood circulation, in which the patient experiences constant fatigue, quickly gets tired, feels pain and heaviness in the legs;
- a acute thrombophlebitis;
- if you have any trophic skin lesions.
For some patients, surgery on varicose veins in the legs may be contraindicated. Barriers to surgical intervention are:
- hypertension;
- a serious infectious disease;
- coronary artery disease;
- the patient's age (over 70 years);
- skin diseases – eczema, erysipelas, etc.;
- the second half of pregnancy.
Surgery is the most effective and safe treatment option for varicose veins. An experienced doctor will be able to quickly remove the pathology, and the patient will return to a normal life without suffering was causing him sickness.
Interventions
The type of surgery depends on the individual characteristics of the disease. Some types of operations, suitable for one person may not work for another. Before surgery, the doctor examines the form of the disease, symptoms and likelihood of complications.
Surgical
The most time consuming and complex procedure associated with high likelihood of complications, phlebectomy is surgery to remove varicose veins. It is prescribed only in cases when other treatments are not able to exert any favorable effect. In the process of this operation in the groin area of the patient make a small (3-5 mm) incisions, through which the affected vein ligated in the place where it empties into the deep vein, then cut and pulled from the legs by means of special probes. After removal of the veins on the cuts imposed absorbable sutures. The operation lasts 1 to 2 hours, while the patient is in hospital less than a day, then go home. A type of phlebectomy is a procedure such as phlebectomy, in which on the body are not made the cuts, and punctures. This method allows to operate with less injury to the skin and to reduce the period of rehabilitation. Stripping is another type of surgical treatment of varicose veins. In the course of this procedure extracted all of Vienna not completely, but only a portion of it that was exposed to varicose. The removal is carried out through punctures in the skin, which avoids suturing.
Sclerotherapy
Less traumatic method of surgical intervention is considered sclerotherapy. It lies in the fact that with the help of ultrasound determines the exact location of the expanded veins, which enter a special substance (sclerosant). This material glues the affected blood vessels, preventing blood from flowing through them. After the operation, to place the patient's veins formed scar tissue, decrease of edema. The patient ceases to feel heaviness and pain in the legs, and if you've had ulcers, they'll heal quickly. Sclerotherapy is of two types:
- Echo-guided sclerotherapy. This operation is used if the affected vein diameter reached 1 cm or more. First, veins are examined with the help of a special device – a duplex scanner, then under his control made the puncture, and then is injected into a vein sclerosant. This procedure allows to reduce the diameter of the affected vessel and restore normal blood flow in it.
- The sclerosing foam. The most safe and completely painless form of sclerotherapy. In the affected vessels are injected with a special foam, which fills it and stops the flow of blood inside the vessel.
For maximum effect, typically, several treatments of sclerotherapy. Recurrence of varicose veins after it almost never happens.
Laser photocoagulation
Surgery to remove varicose leg veins by laser is considered the most technologically advanced kind of struggle with varicose veins and helps eliminate pathologic dilatation in 90% of cases. During this procedure, incisions tissue not made, allowing you to avoid cosmetic defects. Through a puncture in the skin type of laser light guide, which emits light waves. Under their action, there is a dissolution of the patient's vessel. This method has a low number of relapse – cases of the formation of varicose veins occur only in 5% of patients. It can be applied in severe cases when the veins reach large sizes.
Possible consequences and status in the postoperative period
Almost all kinds of operations to eliminate the varicose veins of the legs, are safely and cause any complications in very rare cases. The highest probability of complications and severe leakage of the rehabilitation period occurs when phlebectomy. In the area of the removed vein can cause bruising, and sometimes cuts can bleed, as there are other tributaries of the veins. 2-3 days after surgery, some patients may increase temperature. This is due to aseptic inflammation in the blood that accumulates under the skin. If the accumulated blood will be very much on the veins may form lumps, painful to the touch. If the skin over the lumps acquired a reddish tone, then began a bacterial inflammation. In this case you will need urgent hospitalization. Other possible complications after surgery may include:
- Numbness of the skin, pain. They occur, if during the operation were damaged nerve endings. Over time, the pain will disappear and skin sensitivity will be restored.
- Bruises. Formed by phlebectomy as it is quite a traumatic surgery. After some time, usually not more than a month, they completely disappear. When minimally invasive treatments (sclerotherapy or laser coagulation) bruises are almost never remain.
- Swelling. They can appear, if the patient should not be prescribed in the postoperative period – a lot of moves, doesn't wear special clothes or exposes himself to great physical stress.
After surgery, most patients lead a sedentary lifestyle. Due to inactivity may occur such a dangerous phenomenon of acute deep vein thrombosis of the lower extremities. To prevent it, you must do special exercises, diet and take medications that prevent blood clots.
Recommendations for the prevention of recurrence
Even if the operation to remove varicose veins was carried out successfully, there is always a risk of recurrence of the disease. To the likelihood of recurrence was negligible, it is necessary to observe preventive measures:
- lead an active lifestyle doing sports, often walk in the fresh air;
- in a seated position need to ensure that the posture was smooth, not to put one foot on the other, as it leads to violations of venous blood flow;
- to fight obesity;
- moderately consume coffee and tea;
- every morning, perform gymnastics feet;
- abandon too tight and tight shoes and clothes.
Varicose veins is a disease which even after a complete cure requires adherence to a certain lifestyle. Preventive measures after the operation will need to comply with not the first few months and throughout life. Varicose veins is a disease in which there is a narrowing of the vessel walls of the deep veins and slows blood flow. This disease is much younger nowadays. This is due to a sedentary lifestyle (although a constant work on the legs can trigger an outbreak), movement only in the transport excess weight of the environmental situation in the world, a generic predisposition to blood diseases, etc. the Early stage of varicose veins lends itself well to conservative methods of treatment. But if the disease has gone far and continues to progress, we should think about the operational solution to the problem. True a skilled surgeon the operation to remove the veins – a guarantee of full recovery from debilitating and exhausting diseases. Today, such operations are conducted by highly qualified specialists in medical centers equipped with the most modern equipment, and do not represent any danger for life and health of the patient.
Indications for surgical intervention
Vein removal is used in the following cases:
- extensive varicose veins, covering a large area of the vein;
- incorrect expansion of saphenous veins;
- severe swelling and fatigue of legs;
- pathological the violation of the outflow of blood in the veins;
- non-healing trophic ulcers;
- acute thrombosis and vein occlusion.
Limitations and contraindications
Operation not assigned in the following cases:
- running condition of the varicose disease;
- hypertension 3 degrees or coronary heart disease;
- severe inflammatory and infectious processes;
- senile age;
- 2 and 3 trimesters of pregnancy;
- skin diseases in the exacerbation stage (eczema, erysipelas, dermatitis, etc.)
Before surgery, conduct a thorough investigation of the venous system of the patient, as well as a wide diagnostic testing. Emergency operation shall be appointed when blockage of the veins, thrombophlebitis and recurrent non-healing ulcers.
Types of surgical intervention
Surgery to remove veins on the legs can be carried out using several modern techniques.
Phlebectomy is a popular
In the early stages of the disease is carried out a phlebectomy. Preparation for this type of operation is the most elementary. The patient takes a shower and completely shave the leg and groin. It is very important that before the surgery, the skin on the leg was perfectly healthy and the skin is not broken. Before the operation the patient clean the intestines and carry out research on allergic reactions to medications. The operation lasts up to 2 hours under local anesthesia. Removal of the saphenous vein is completely safe for the human body. During the operation, can spend the extravascular correction of valves to restore the flow of blood. The operation begins with an incision length of up to five cm in the groin, and a length of two cm at the ankle. The rest of the incisions are made under large venous nodes. The cuts are shallow and narrow. Through an incision in the groin is injected into a vein of the venous extractor (in the form of a thin wire with a round tip at the end). With the help of this tool, the surgeon removes the affected vein. Then the incisions are sutured and the operation is ended. Of course, the leg is closed sterilized gauze and placed on top an elastic band. After 1-2 days the patient may already move independently. After phlebectomy, the patient wears stockings (or bandages) for 2 months and takes venotonic for the restoration of the veins. In some cases, appoint the phlebectomy, in this case, the leg made a small incision (under local anesthesia) through which removes the damaged parts of Vienna or even Vienna completely.
Sclerotherapy is the painless removal of varicose veins
Today is a special popularity was gained by echo-guided sclerotherapy— treatment of varicose veins by injections. When this is injected into a vein substance – sclerosant, which destroys the inner layer of blood vessels, then the middle layers are fused and form a fall of Vienna. This method is the most gentle, but for a lasting effect you should spend a few procedures and will take about six months for rehabilitation. This type of surgery, and foam sclerotherapy can be used only when damage to the veins of small diameter and with a large number of "vascular asterisks". The vein will be blowing sclerosant, the effectiveness of which increases due to the large increase in the area of interaction with the inner side of the vessel. And in addition, because of its particular consistency of foam lingers in the vessel, increasing the time of exposure of the drug to the affected vessels. Therefore, when foam sclerotherapy number of sessions is reduced significantly.
Laser in phlebology
The most advanced method of vein removal – laser, this laser intravascular coagulation. The surface of the vein from the inside is processed by the laser through a barely noticeable puncture. In this case, the leg is overlaid with a sterile elastic bandage and five hours later the patient is able to walk independently. Both of these methods are considered malotravmaticheskaya and painless. The patient can go home the same day on their feet.
Possible consequences
After any, even the most gentle of surgery to remove veins on the legs are bruises, bruises and other consequences that will be for some time to disturb. Some time after the operation it is better to sleep with raised legs to improve blood flow. A fairly common complication after surgery is recurrence of varicose veins, if the patient has a generic predisposition and he has not changed his lifestyle. Very rarely damage during the operation, adjacent vessel or nerve. But this complication is completely excluded from a qualified specialist. After phlebectomy legs remain inconspicuous small scars.