For most of the 20th century, a combined phlebectomy was considered the gold standard of surgical treatment of varicose veins, in which the damaged veins were completely removed, along with adjacent tributaries. Now this technique is considered outdated. She was replaced by new modern methods of treating varicose veins. With their help, you can treat patients on an outpatient basis and not violate the habitual lifestyle for them.
Treatment of varicose veins at home, folk remedies and/or tablets from varicose veins will not be able to solve the problem radically. In this article, we will only talk about surgical methods of getting rid of veins on the legs.
What is combined phlebectomy and what are its shortcomings
Combined phlebectomy is an operation to remove the damaged vein, which is carried out through a section of the skin under general or spinal anesthesia. During the operation, the surgeon first distinguishes the trunk subcutaneous vein at the place of its confluence into deep. The blood vessel and tributaries in this place are bandaged and crossed. Then, using different techniques, the doctor removes the cut off vein and tributaries of the main vein. The operation lasts about two hours, after which the patient will remain under the supervision of doctors in a hospital for about a week.
Combined phlebectomy has a number of significant disadvantages:
- large traumatic surgical intervention;
- a long rehabilitation period - the patient becomes incapable of work for up to three months;
- Big scars and scars remain at the site of surgical manipulations;
- There is a risk of severe complications, the most dangerous of which is the pulmonary artery thromboembolism.
Many people who have undergone the operation to remove veins are faced with impaired sensitivity of the skin of the limb. In some of them, the sensitivity is completely absent, in others, even the touch of clothes causes severe pain.
Currently combined phlebectomy is widely used to treat patients in municipal hospitals in the regions. In large medical centers, innovative techniques were replaced by Evvlk (endenosis laser coagulation (sponge) of veins), rchuis (radio frequency obstration), sclerotherapy, miniflebectomy, mechanochemical and adhesive lining of veins.
Advantages of modern methods of surgical treatment of varicose veins
The above treatment methods are more effective and less dangerous for the patient, when compared with classical combined phlebectomy. These methods have several advantages:
- Most often, the patient is not hospitalized - after a few hours and often and immediately after the operation he goes home;
- There are no ugly scars and scars on the skin;
- During the operation, the patient is conscious;
- There is no long rehabilitation - you can return to the usual lifestyle the next day, and you can walk on the same day;
- The risks of infection are minimal.
Endovasal laser coagulation of veins (Evlk) - Removing veins with a laser
Laser coagulation is one of the thermal methods for treating varicose veins. During the operation, the doctor makes a small puncture on the skin of the limbs, through which under the control of the ultrasound in Vienna introduces a light conductive fiber. Under the influence of a laser ray, the venous wall heats up, the vein is scarred. As a result, a pathological (perverted) blood flow on it ceases, and a shortened vein is absorbed in six months or a year.
Laser coagulation is used to treat varicose veins at different stages. The operation lasts no more than an hour, in most cases it will take only 30 minutes.
Evlk advantages:
- The procedure does not require hospitalization and long -term preoperative preparation;
- The skin does not cut, which means there will be no ugly scars;
- All consumables, including lamps, disposable - the risk of infection is reduced to almost zero.
The next day after the operation, the person goes to work, and to the usual physical exertion, to visit a bath or sauna can return after 2-3 weeks. For comparison, rehabilitation after classical phlebectomy will take about three months.
Radio frequency prison (rchu) veins
Under the radio frequency prison (RFO) of the veins is understood as an operation that is carried out using a special device emitting radio frequency of certain parameters. The doctor makes a special syringe a puncture of the vein through which the adapter introduces. Through it, a radio frequency catheter with sensors is introduced to the desired area.
A high -frequency current is supplied to the inner surface of the damaged vein, under the influence of which the venous clearance is removed. The catheter acts only on a vein, the adjacent fabrics are not affected.
The advantages of rchu:
- The operation does not take much time - usually no more than 40 minutes;
- To treat the damaged vein with a high -frequency current, you need only one small puncture;
- There are no scars after the operation;
- Most people have no pain during manipulations, so the operation is performed without anesthesia;
- After the procedure, hospitalization is not needed.
Against the background of traditional phlebectomy, the number of complications after radio frequency prostration is extremely low. Deep vein thrombosis occurs only in 0. 1% of cases, therefore, RCH is considered one of the safest methods of surgical treatment of veins, as well as Evlk.
Today, Evlk and RFO are the gold standard among all modern methods of surgical treatment of varicose veins.
Sclerotherapy in the treatment of vein diseases
Sclerotherapy is a method for removing varicose veins by introducing a damaged vessel of a sclerosing solution or foam into the lumen. Under their influence, the vein site is "glued", the pathological flow of blood on it ceases. In the future, the processed vein turns into a fibrous fabric and is absorbed.
Advantages of sclerotherapy:
- low, in comparison with Evlk and RFO, the cost of the procedure;
- there is no long -term preoperative preparation;
- Hospitalization is not needed - the procedure is carried out on an outpatient basis;
- general anesthesia is not needed - manipulations are almost painless for most patients;
- Slight risk of complications.
Sclerotherapy is effective at various stages of the development of the disease. In many cases, the method can be combined with Evvk and RFA, but the cost of the operation will be higher.
Adhesive linen of veins
This method of treating varicose veins is one of the newest. Its essence is that a special glue is introduced into the lumen of the patient, which leads to the gluing of the walls of the veins. After such an intervention, the sore vein immediately stops breaking venous blood flow, and is completely absorbed over time.
The advantages of the methodology are:
- The procedure is performed on an outpatient basis
- Do not need compression knitwear after intervention
- there is no need to perform anesthesia
- It is performed after 1 puncture
The disadvantages include the following:
- The procedure can not be performed by all people
- Pretty high price.
In conclusion about modern methods of treating varicose veins
The method of surgical treatment is selected by the doctor. At the same time, we take into account the state of health and features of the pathological process. All methods have their pros and cons. One person can use either one modern method of treating varicose veins or their combination. It depends on the features of the structure of the veins, the nature and stage of the course of varicose veins in each case. Error an appointment with a phlebologist to get competent consultation and choose the correct tactics of treating your disease.