Myths about varicose veins. Myth 5: the treatment of varicose veins is hospitals and scars, it is better to endure until old age

There are many stereotypes and fears about the treatment of varicose veins, which make people slow to visit doctors and solve the problem. We will devote this article to fears of surgical intervention and related inconveniences: painful procedures, cosmetic defects after surgery, stay in a hospital, etc.

What do fears lead to?

Unfortunately, stereotypes regarding surgical treatment of varicose veins that have developed in our country do not allow patients to adequately perceive the need for surgery, creating a so-called ""vicious circle"". The main reasons for patients' dissatisfaction with operations are as follows: mandatory hospitalization; sometimes prolonged, pronounced trauma of interventions due to a large number of incisions; fairly frequent and significant number of postoperative complications; the need to wear elastic bandages for a long time; painful postoperative period and the need for very unpleasant daily dressings; a sharp decrease in physical activity; a significant period of incapacity for work; lack of cosmetic effect of standard operations; a long period of rehabilitation; inability to lead a normal lifestyle; a large number of relapses, that is, there are new varicose veins.

Due to the listed factors, patients are in no hurry to seek medical help. However, the tendency to postpone the treatment of the disease until later leads to the predominance of advanced forms of the disease in our country, when there is no way to do without serious surgical intervention. In turn, if surgical treatment of late forms of varicose veins is necessary, patients have to face all the negative points listed above.

Why is it necessary to debunk myths?

Previously, the lack of adequate information on patients about their diseases contributed to the development of fears and stereotypes, as well as the fact that the treatment of varicose veins was often not carried out by narrow specialists, but by surgeons who did not have the necessary qualifications, training and experience, which led to inadequate performance of operations. But in recent years, modern phlebology has undergone a real revolution in approaches to surgical treatment of varicose veins. Low-traumatic operations, improved and modernized sclerotherapy techniques have been developed, implemented in wide practice and have already become the ""gold standard"" of treatment around the world. The skills of ultrasound examination are actively used and considered absolutely necessary for a modern phlebologist to ensure the maximum effectiveness of the treatment being carried out. Such global changes made it possible to put the usual standard operations with all their unattractiveness far into the background.

Currently, effective methods of treating varicose veins have been developed, such as endovenous laser obliteration, radiofrequency ablation of veins, improved surgical sclerotherapy techniques, as well as steam exposure and cryodestruction of veins. Currently, such a method of vein removal as miniphlebectomy is standard. Research into new technologies for the treatment of main subcutaneous veins with cyanoacrylate glue and mechano-chemical sclerotherapy is ongoing. This led to a certain breakthrough in the treatment of varicose veins and a revolution in approaches to the treatment of such patients.

The ""gold standard"" treatment of varicose veins

What can a modern qualified phlebologist offer to his patients? So, after consulting a specialist, an ultrasound was performed and signs of valvular insufficiency of the main superficial veins were established, which is an indication for operative treatment. The most common method, which is currently the ""gold standard"" for the treatment of varicose veins worldwide, is the endovenous laser obliteration (EVLO) method. It may also be called ablation (EVLA) or coagulation (EVLC), but all these methods are the same intervention, they are just different categories and concepts that reflect different processes or results of the procedure.

Undisputed and recognized advantages of EULO are as follows:

1. The operation is performed on an outpatient basis. That is, there is no need to lie in the hospital. The patient chooses a suitable time and place for the examination. For example, you come to the clinic in the morning on the day of surgery, after surgery, you are cared for for 30-60 minutes, and then you are already released home, monitoring only by phone. At the same time, there are no significant restrictions before the operation.
2. The operation is performed under local anesthesia. With the help of a special device under high pressure, a certain solution of highly diluted anesthetic is injected into the areas where surgical manipulations are required. The patient feels injections and injected liquid, pain sensations are either absent at all, or they are quite tolerable. Such anesthesia, in addition to being absolutely safe due to the significant dilution of the local anesthetic, does not affect any of the body's vital functions and does not cause their changes during surgery. The injected anesthetic also provides an analgesic effect in the early postoperative period. But the most important thing is that this type of anesthesia allows the patient to stand up from the operating table on his own right after the intervention and to walk on his own right away, fully loading both legs. The operated leg does not bother you at all when walking. The use of this type of anesthesia allows to safely operate on patients at any stage of the disease, at any age, with any compensated chronic concomitant diseases.
3. Ideally, the operation is performed without a single incision. Sometimes, with a significant size of varicose veins, it may be necessary to make mini-incisions of the skin, which are sewn up with a cosmetic suture. Thus, tissues are practically not damaged, surgical manipulations are minimal and gentle, accordingly, there is no surgical traumatization of tissues, as during a conventional operation.
4. The intervention must be performed under constant visual ultrasound control. Immediately before the operation, an ultrasound is performed, a map of the affected veins is drawn on the skin of the leg, all anatomical features of the structure of the venous system are examined, the nature and localization of the vein lesion is clarified and severity of changes in blood circulation. The sizes of main veins in different segments are noted, which determines the selection of technical parameters of the procedure. Such a thorough examination is carried out by the surgeon who operates, so he must have the appropriate training and experience. This allows you to guarantee the accuracy and adequacy of the procedure, since only a vascular surgeon can thoroughly understand and evaluate the identified disorders, as well as adequately select treatment tactics and technical parameters individually for each individual patient, since the venous system of human legs is quite variable and diverse. Nowadays, the attitude towards the treatment of varicose veins is as follows: ""It is not necessary to remove what is functioning normally at the moment."" Such an approach can be ensured only at the expense of the most accurate ultrasound diagnostics and an individual approach. In addition, all stages of surgical intervention are carried out under ultrasound control, and not blindly, as in standard surgery. Such control ensures the removal of all affected segments and the maximum effectiveness of the intervention.
5. In most cases, the early postoperative period is completely painless. There is no restriction of motor or physical activity, as the operated leg does not bother.
6. Only two bandages are needed. The first one is carried out the next day after the operation, there is also a change of plasters used to seal the punctures, a change of the tight elastic bandage, required on the first day after the operation, to a more comfortable and loose one. Second dressing - on the seventh day, when plasters and sutures are removed from postoperative wounds, if there are any, the patient is helped to put on a compression jersey for the first time, and instructions are given on how to care for it. These bandages are light and painless.
7. There is no pain syndrome, there is no limitation of physical activity. This allows the absolute majority of patients to lead a normal lifestyle, without significant restrictions, to continue working as usual the next day. The regimen of mandatory compression therapy is only one month. It will also be possible to play sports just one month after the operation.

So, summing up, I would like to highlight a few main points:

• Varicose veins, being a hereditary defect, is a chronic disease that requires constant control, supervision and, if necessary, different treatment. You can compare this disease with any chronic disease, such as coronary heart disease, hypertension, diabetes, peptic ulcer, etc. All these diseases have stages of exacerbation and remission, therefore, in the stage of remission, they require compliance with a certain regime and supervision, and in the period of exacerbation - certain treatment.
• Once appearing, varicose veins never disappear, but only increase over time, while complaints always increase. This disease is quite insidious.
• The problem of treating varicose veins is exclusively surgical, no other methods of treatment (pills, ointments, leeches, folk remedies) are effective, but can only reduce the manifestations of the disease and reduce complaints. The only justified therapy at any stage is compression therapy.
• Modern approaches to the surgical treatment of varicose veins are radically different from the previous ones. The technological capabilities made it possible to take into account all the wishes of the patients, so that the surgical treatment became comfortable, painless, quick and minimally traumatic, without any restrictions in the usual way of life.
• At any stage of the disease, a professional specialist will be able to provide assistance to absolutely any patient, taking into account the individual characteristics of his illness. The arsenal of surgical technologies is extremely wide and allows you to freely combine them as needed, always achieving success and defeating the disease. Timely referral to a specialist and choosing a qualified phlebologist will allow you to quickly and effectively get rid of varicose veins.