Varicose veins are a serious disease that is not only an aesthetic defect, but also leads to circulatory disorders. Human life is getting worse. Conservative therapy can only have an effect in the initial stages of the development of pathology; in the presence of complications, a combined phlebectomy is prescribed to the patient.
What is an operation?
Combined phlebectomy is the removal of affected blood vessels. Some pathologies lead to an increase in their clearance, as a result of which the blood pressure decreases. In this case, the heart should work much more.
To get rid of the problem, the vessel must be removed. The main task of combined phlebectomy is the normalization of blood circulation. Perform it in an inpatient or outpatient setting. It all depends on the severity of the lesion. Intervention involves the use of several techniques.
Indications for use
There are various indications and contraindications for combined phlebectomy. The operation is assigned in the presence of such problems:
- Pain and burning sensation in the lower extremities.
- Swelling of the legs and their chronic fatigue.
- Bloated veins.
- Thrombophlebitis in the initial stage.
- Stagnation of blood in the legs.
- Venous insufficiency.
- The expansion of the diameter of the large saphenous vein.
- Soft tissue and skin ulcers.
Combined phlebectomy is performed if the pathology spreads above the knee.
Contraindications
If varicose veins are diagnosed, vein removal may not always be possible. There are such contraindications for surgery:
- Persistent increase in pressure.
- Coronary heart disease.
- Immune problems.
- Elderly age.
- Diabetes.
- Acute thrombosis of deep vessels.
- Skin diseases of an inflammatory or infectious nature.
- Pregnancy.
- Breast-feeding.
- Atherosclerosis of the legs.
- Menstruation in women.
If a person is at risk, then with varicose veins, removal of the affected areas can be prescribed, but there is already a question about the type of procedure.
Advantages of surgical intervention
With varicose veins, the operation will help get rid of the symptoms. It has the following advantages:
- Reducing the likelihood of further development of the disease, since after the removal of large vessels, they will not be able to grow again.
- It is possible to perform operations simultaneously on two limbs.
- Achieving a noticeable cosmetic effect.
- Short rehabilitation period.
- After the intervention, the scars are almost invisible.
The indicated operation can be carried out by compulsory medical insurance. In addition, combined phlebectomy, the course of the operation involves the combination of several procedures, is carried out quickly and simply.
Operation disadvantages
Despite all the advantages, such a procedure may have disadvantages. First of all, it requires anesthesia, which is not indicated for everyone.
The operation must be performed by an experienced surgeon, otherwise there is a risk of damage to healthy vessels, nerve endings. After the intervention, bruises and age spots often appear. More often they pass during the first weeks of the postoperative period, but spots can remain for life.
Possible complications
After a combined phlebectomy, the reviews are mostly positive. A person's life activity improves, he can walk without pain. However, the procedure can give some complications:
- Severe bleeding during surgery. He is not always able to quickly stop. More often, such a complication occurs in those patients who have blood problems.
- Constant pain in the legs, the appearance of seals, which can also be painful.
- Decreased sensitivity in the limbs. This condition is characteristic of those patients whose nerves were damaged during the operation,
- Suppurations. This complication appears due to non-compliance with the rules of septic tanks and antiseptics.
Sometimes a patient develops deep vein thrombosis after the intervention. In case of complications, the patient requires drug therapy. It will help to quickly remove postoperative symptoms.
Patient examination
Before removing damaged vessels, a person should be carefully examined. The main diagnostic method is an ultrasound of the veins and vessels of the lower extremities. The study will assess the severity of the pathology, the location of the damaged vessels and choose the appropriate method of removal.
During diagnosis, vein marking is done. This requires duplex ultrasound scanning. An additional analysis of urine and blood, a blood test (coagulogram). To prevent complications, it is also necessary to carry out fluorography, ECG.
Preparatory Activities
For phlebectomy, preliminary preparation is needed. Here the patient needs to wear compression underwear for several weeks, take prescribed medications, and also undergo a course of physiotherapeutic procedures.
Immediately before the intervention, you should shave your legs, prepare compression stockings or an elastic bandage. It is forbidden to have dinner or drink medicine the night before. You also need to make an enema, since it is forbidden to go to the toilet for several days after the operation. You should also take a shower.
Stages
When prescribing a phlebectomy of the veins of the lower extremities, the course of the operation involves the following steps:
- Crossectomy At this stage, the large saphenous vein is ligated. After that, at the place where it flows into the deep venous system, it intersects. The movement of blood through the vessels stops. This stage can be carried out both at the beginning of the operation, and at the time of its completion. It is not always needed, only when the risk of deep vein thrombosis is increased. For removal, an incision is made on the inside of the leg under the knee or in the inguinal region.
- Stripping. After crossing the vein, its complete removal is carried out. Such a procedure is radical. However, only a small part of the vessel can be removed in this way.
- Bandaging of perforating vessels. It is carried out after the subcutaneous vessels are removed. Through such veins superficial and deep vessels are connected.
- Miniflebectomy. This stage is considered final. It involves the removal of damaged vein fragments. Such a procedure can be used as an independent full intervention.
After surgery, small cosmetic stitches are applied to the incisions. After skin healing, traces of them are almost invisible. Sometimes, to connect the soft tissues, the edges of the incision are glued using special surgical adhesives.
If necessary, some of these steps can be replaced by more gentle methods of treating varicose veins: radiofrequency or laser. The standard duration of the procedure does not exceed 2 hours.
Rehabilitation process
After combined phlebectomy, the postoperative period requires full compliance with the recommendations of the doctor. Its duration is 6 months. The rehabilitation period begins even while the patient is in the hospital. Seams after removal are removed after 7 days.
During the first 3-4 hours, the patient remains in bed. But he should not be passive. At this time, he performs simple exercises: turns with ankles, turns from side to side. Such exercises will help restore normal blood circulation.
A month after the intervention, the patient will need to wear compression stockings. Moreover, they must be worn around the clock. Such underwear improves blood flow.
You can wash your operated leg only after removing the sutures. This should be done very carefully. After this period, stockings may be removed at night. It is forbidden to tear off the crusts formed at the site of the seams. This area needs to be lubricated with antimicrobial agents for some time. They will help prevent infection from entering the wound surface.
Within 2-3 months after the intervention, the patient should not go to the bath, visit the sauna, take a hot bath. At the same time, compression garments should continue to be worn during the day. In the first days after phlebectomy, the patient is prescribed phlebotonics and pain medications.
In addition, the following drugs are prescribed to the patient:
- Medicines based on salicylic acid, Pentoxifylline. They normalize microcirculation.
- Preparations containing ginkgo biloba.
- Antioxidants.
To accelerate recovery, multivitamin and mineral complexes will be needed. Drugs are prescribed in a course that lasts 14 days.
In addition, physiotherapeutic procedures are prescribed for the operated person. They prevent the development of inflammatory processes and trophic disorders. The patient will be helped by quartz irradiation, UHF therapy.
What to do at home?
During recovery, you need to engage in swimming, walk more in the fresh air. The following recommendations of specialists should also be observed:
- Wear only comfortable shoes that will not tighten or crush your foot.
- Do not lift more than a kilogram.
- During rest, it is required to keep the limbs on a raised platform.
- It is forbidden for a long time to be in the same position. If a person has sedentary work, then it is worth periodically kneading both legs.
- After discharge, the patient is assigned moderate physical activity (physiotherapy exercises). It should be done regularly. Exercises are performed standing on the floor (tilting down, with the fingers touching the floor and keeping the legs straight), sitting on the floor (tilting forward with legs wide apart), kneeling (walking on your knees back and forth with your hands apart ) You can also perform circular leg movements, standing on toes.
- Stop smoking and drinking alcohol.
- Eat rationally and fully. The diet involves the use of those products that thin the blood, strengthen the vascular wall. There should be no fat in the diet. It is required to increase the number of fruits and vegetables.
If itching appears in the scar area, then it should be treated with iodine. Self-massage will help to recover faster. It prevents the appearance of blood clots, stagnation. Any movements must be performed carefully. Massage should be prescribed by a doctor.
Varicose veins are a dangerous disease. With untimely treatment, it can provoke tissue death and loss of limbs. The operation to remove the affected vessels is a radical method of combating pathology, but it allows you to restore normal life.