Treatment of varicose veins. Classical phlebectomy, laser treatment. What to choose?

Duplex scanning of vessels (veins) of the lower extremities

Treatment of varicose veins on the legs with medications is far from always effective. It is especially difficult to cure varicose veins if it is in an advanced stage. In this case, surgery is the only option for eliminating the disease. Classical phlebectomy, mini-phlebectomy, sclerotherapy, laser vein removal are effective methods for solving the problem of varicose veins. However, not all women suffering from varicose veins immediately decide on one of them. The fear of the surgeon and the operating room, the fear of general anesthesia and complications stop the patients, so they are afraid for a long time to go to the doctor, relying on some form of home treatment. In the meantime, varicose veins progresses, and the condition worsens.

Will the varicose veins "come out" again? Do you have to hide the ugly stitches after the operation? Do you really have to wear special jersey for a whole year after the operation? These and other questions torment women and remain unanswered, and such an operation necessary for the health of the legs is postponed for months, and often for years. But today, not only classical phlebectomy is performed, which is a full-fledged surgical intervention (with general anesthesia, a long period of recovery and return to normal life), but also mini-surgery on veins, which are done on an outpatient basis, under local anesthesia, and after which it is not even requiredlong sick leave.

The choice of treatment for varicose veins

Any of the listed operations, whether it be classic phlebectomy, mini-phlebectomy, laser or sclerotherapy, is prescribed by a doctor taking into account the stage of varicose veins of the lower extremities and the patient's condition. It is impossible to independently choose the method of removing varicose veins, it is determined by the doctor after the examination:

  • duplex scanning of the vessels (veins) of the lower extremities is universal and informative,
  • rarely, in complex diagnostic cases, the methods of X-ray contrast phlebography and computed tomography are used.

Features of surgical methods for the treatment of varicose veins

Various types of operations are widely practiced in inpatient and outpatient settings. Each of the methods has its own indications and contraindications, pros and cons.

Classic vein removal surgery

Quite often, the attending physician opts forclassical phlebectomy. . .

The operation is performed under general or spinal anesthesia. During the operation, a large saphenous vein is removed along with varicose veins. After the operation, you need to stay in the hospital for several days, then at home for several weeks. The stitches are removed on the 7-10th day after the operation, the healing time is individual.

The advantageclassical phlebectomyis highly effective in the treatment of varicose veins of moderate and severe degree. The technique has been used for many decades, has proven itself successfully and has allowed millions of patients to keep their feet healthy.

Among the disadvantages are a long recovery period, a deterioration in general well-being after surgery and the inability to immediately return to the usual routine (work, driving, long walking distances), as well as an insufficient cosmetic effect that lasts for several months.

Mini phlebectomy

Unlike the classic operation, with a mini-phlebectomy, removal is performedindividual superficial affected veinsthrough multiple small incisions or punctures. The surgeon uses special instruments (hooks, mini scalpels) of a small size. The intervention is carried out at different stages of the disease and can be combined with other methods (laser removal, sclerotherapy).

The advantages of the method:

  • outpatient surgery, being under the supervision of doctors for several hours after the manipulation,
  • local anesthesia,
  • fast healing of punctures and micro-incisions, no stitches,
  • the ability to immediately return to the usual routine, as well as an excellent cosmetic effect.

After the operation, some complications are possible - hematomas in the area of incisions and punctures, discoloration of the skin in the area of the operated veins, but in general these risks are minimal.

Laser removal

Laser removal of varicose veins(endovasal laser coagulation of veins) is an innovative method that is widely used and highly effective.

During intravascular (endovasal) surgery, a small incision or puncture is made in the skin: under ultrasound control, a long light guide is inserted into the vein through a catheter. Through it, a laser beam acts on the walls of the vein, "gluing" them.

The advantage of this methodis the operation on an outpatient basis, under local anesthesia.Laser removal of varicose veinscan be combined with mini-phlebectomy, sclerotherapy, gives an excellent cosmetic effect, which is very important for women of any age. The catheter insertion site is sealed with a special plaster, which is removed after 8-10 days, no sutures are applied. After the operation, you can live in your usual rhythm, practically without restrictions.

Compared to classic phlebectomylaser vein removal for varicose veinsconsidered less traumatic and safer.

But it should be noted that the method is not considered universal for the treatment of patients with varicose veins (like any other). Carrying out such an operation, like the classical removal of veins, is possible only after a full examination of the patient, taking into account all the features of the course of the disease.

Choosing a clinic for the treatment of varicose veins and surgery

The surgeon examines the veins of the patient before the operation

Conservative and surgical treatment of varicose veins is carried out today in many public and private medical centers. The clinic, which you entrust your health, must have a serious reputation and experienced doctors who are proficient in various techniques of vein surgery.

In the conditions of high-tech operating rooms, operations of classical phlebectomy, mini-phlebectomy, sclerotherapy (in various versions), etc. are carried out. It is important that the choice of the method by the doctor is always strictly justified by the clinical picture and discussed with the patient, explaining the pros and cons of the methods, the risks of consequences and possible complications. For example, inclinic for the treatment of varicose veinsit is not always advisable to use minimally invasive ("light") techniques. Contraindications for this: severe varicose veins, thrombophlebitis, blood clotting disorders and others. In this case, a combined operation is performed to achieve a good result.

For doctorsclinic dealing with the treatment of varicose veins, the results of therapy and the condition of patients are very important - both in the early and late postoperative period. That is why surgeons are always in touch and ready to answer any questions of interest to the operated patients.

Phlebologist's advice

Despite the choice of surgical techniques for the removal of varicose veins and the possibility of small outpatient interventions, any operation involves a rehabilitation period and a careful attitude to one's health. Therefore, from the very first appointment until the end of the medical supervision after the operation, allphlebologist's recommendation:

  • first of all, wearing medical jersey; special underwear is put on immediately after surgery, after phlebectomy. The first two days, as a rule, it is recommended to wear jersey around the clock. Further, daytime wear for 3-6 weeks (according to the testimony of a doctor);
  • after endovasal interventions (laser therapy), which are not combined with any other methods, compression therapy is not required, in the case of a combined operation, wearing is required for a month or two. The first two days the knitwear is left overnight.
  • othersphlebologist's recommendationsrelate to physical activity and a healthy lifestyle, control of excess weight and changes in working conditions, if it involves a prolonged static load on the legs. You need to walk for 40-60 minutes daily. You can add special exercises to strengthen your veins and blood vessels to your daily walks. During the first two months after the operation, perform all physical exercises in compression hosiery. Remove squats and weight lifting (dumbbells, barbells) from the complex. Also, do not put a lot of stress on the lower abdomen.

In general, the most important condition for the successful correction of varicose veins is the cooperation of the doctor and the patient. Trust in the attending physician, adherence to all his recommendations and subsequent observance of the rules of prevention contributes to the preservation of the health and beauty of the legs.

03.07.2021