Surgery for varicose veins of the lower extremities is prescribed under the following circumstances:
- if the saphenous veins are enlarged as a result of physiological pathology;
- if the disease is in an advanced stage, when the treatment of varicose veins with drugs or folk remedies no longer helps;
- with the formation of trophic ulcers on the skin;
- if there are violations of the vascular circulation, as a result of which the patient experiences constant fatigue, quickly gets tired, feels pain and heaviness in the legs;
- if acute thrombophlebitis has formed;
- if there are trophic skin lesions.
For some patients, surgery for varicose veins in the legs may be contraindicated. Factors that prevent surgical intervention are:
- severe infectious diseases;
- ischemic disease;
- patient's age (over 70 years);
- skin diseases - eczema, erysipelas, etc. ;
- second half of pregnancy.
Surgery is the most effective and safest treatment option for varicose veins. An experienced doctor will be able to quickly eliminate the pathology, and the patient will return to normal life without experiencing the suffering that the disease caused him.
Types of intervention
The type of surgical intervention is determined depending on the individual characteristics of the course of the disease. Some types of surgery that are suitable for one person may not be suitable for another. Before prescribing an operation, the doctor studies the form of the disease, the symptoms, as well as the likelihood of complications.
The most time-consuming and complex procedure associated with a high likelihood of complications is phlebectomy, an operation to remove varicose veins. It is prescribed only in cases where other methods of treatment are not able to have any beneficial effect.
During this operation, small (3-5 mm) incisions are made in the patient's inguinal region, through which the affected vein is tied up at the place where it flows into the deep vein, then it is dissected and pulled out of the leg using special probes. After removal of the vein, absorbable sutures are applied to the incision sites. The operation lasts from 1 to 2 hours, while the patient stays in the hospital for no more than a day, then he is allowed to go home.
A variation of phlebectomy is a procedure such as miniphlebectomy, in which not incisions are made on the body, but punctures. This method allows you to perform surgery with less trauma to the skin and shorten the rehabilitation period.
Stripping is another type of surgical treatment for varicose veins. During this procedure, not the entire vein is completely removed, but only a small section of it, which has undergone varicose expansion. Removal is carried out through punctures in the skin, which avoids suturing.
Sclerotherapy is considered a less traumatic method of surgical intervention. It lies in the fact that with the help of ultrasound, the exact location of the dilated vein is determined, into which a special substance (sclerosant) is injected. This substance sticks together the affected vessels, preventing the flow of blood through them. After this operation, scar tissue is formed at the site of the diseased vein, swelling disappears. The patient is no longer tormented by heaviness and pain in the legs, and if there were trophic ulcers, they will quickly heal.
Sclerotherapy is of two types:
echosclerotherapy. This operation is used if the diameter of the affected veins has reached 1 cm or more. First, the veins are examined using a special device - a duplex scanner, then a puncture is made under its control, after which a sclerosant is injected into the vein. This procedure allows you to reduce the diameter of the affected vessel and restore the normal movement of blood through it.
Foam sclerosing. The safest and most painless type of sclerotherapy. A special foam is injected into the affected vessel, which fills it and stops the blood flow inside this vessel. For maximum effect, several sclerotherapy procedures are usually performed. There are almost no recurrences of varicose veins after it.
The operation to remove varicose veins on the legs with a laser is considered the most technologically advanced type of fight against varicose veins and helps to eliminate pathological varicose veins in 90% of patients. During this procedure, tissue incisions are not made, which avoids cosmetic defects.
A laser light guide is inserted through a puncture in the skin, which emits light waves. Under their action, the diseased vessel is dissolved. This method is characterized by a low number of relapses - repeated cases of varicose veins occur only in 5% of patients.
Similar to laser coagulation method of treatment of varicose veins isradiofrequency obliteration. The essence of the method is the exposure of the diseased vein to microwaves that heat the vessel, causing it to "solder". This method of treatment is considered the simplest and most painless. It can also be used in severe cases when the veins reach large sizes. How to do the operation to remove varicose veins on the legs with a laser, see the video: Do not watch if you are particularly impressionable!
Possible consequences and condition in the postoperative period
Almost all types of operations performed to eliminate varicose veins of the legs go well and cause any complications in very rare cases.
The greatest likelihood of complications and a difficult course of the rehabilitation period is observed with phlebectomy. Hematomas may occur in the region of the removed vein, and sometimes blood may flow from the incisions, since there are tributaries of other veins nearby.
Some patients may develop a fever 2-3 days after surgery. This is due to aseptic inflammatory processes in the blood, which accumulates under the skin. If there is a lot of accumulated blood, lumps can form on the veins, painful to the touch.
If the skin over the lumps has acquired a reddish tint, then bacterial inflammation has begun. In this case, urgent hospitalization will be required. Other possible complications after surgery may include:
Skin numbness, pain sensations. They occur if the nerve endings were damaged during the operation. Over time, the pain will disappear and the sensitivity of the skin will be restored.
bruises. They are formed during phlebectomy, since this is a rather traumatic operation. After some time, usually no more than a month, they completely disappear. With minimally invasive treatments (sclerotherapy or laser photocoagulation), bruising almost never remains.
Edema. They can appear if the patient does not follow the doctor's instructions in the postoperative period - he moves a lot, does not wear special clothes, or exposes himself to great physical exertion.
After surgery, most patients lead an inactive lifestyle. Due to hypodynamia, such a dangerous phenomenon as acute deep vein thrombosis of the lower extremities can occur. To prevent it, you need to do special exercises, follow a diet and take drugs that prevent thrombosis - Curantil, Heparin or Aspirin.
Rehabilitation after removal of varicose veins of the lower extremities
Compliance with the doctor's indications in the postoperative period is the most important part of the treatment and prevention of recurrence of varicose veins. Most patients are advised to:
- Tightly bandage the leg with an elastic bandage.
- Wear special compression underwear - stockings or tights.
- Do not lift weights exceeding 10 kg for the first six months after surgery.
- Go in for sports with moderate physical activity - walking, swimming, cycling.
- Control body weight if you have problems with being overweight.
- Annually take a course of venotonic drugs.
Within 3 days after the operation, patients are strictly forbidden to smoke and drink alcohol, sunbathe, lift weights, drive a car and take hot baths.
When pain occurs in the operated leg, a light massage can help, which can be done independently.
Relapse Prevention Recommendations
Even if the operation to eliminate varicose veins was carried out successfully, there is always a risk of re-development of the disease. To minimize the likelihood of recurrence, it is necessary to observe preventive measures:
- lead an active lifestyle - play sports, often walk in the fresh air;
- in a sitting position, you need to ensure that the posture is even, do not put one leg on the other, as this leads to impaired venous blood flow;
- fight overweight;
- drink coffee and tea in moderation;
- do leg exercises every morning;
- refuse too tight and tight shoes and clothes.
Varicose veins are a disease that, even after a complete cure, requires adherence to a certain lifestyle. Preventive measures after surgery will need to be observed not for the first few months, but throughout life. This is the only way to normalize the state of your body and eliminate the likelihood of a recurrence of the disease.