Πληροφορίες και Συγκατάθεση για επέμβαση χρόνιας φλεβικής ανεπάρκειας
The intended benefits: in uncomplicated varicose veins to improve uncomfortable symptoms, such as aching, throbbing, or itching. For more severe vein problems including skin changes, to improve the risk of developing an ulcer or to help sustained healing of an ulcer. Treatment also slightly reduces the risk of a deep vein thrombosis (DVT) and pulmonary embolism (PE). One or both legs may be treated and with either stripping or phlebectomies or both. The operation is almost done with a general anaesthetic.
Alternative treatments: support stockings – these can improve discomfort and reduce the risk of vein complications and are often appropriate for milder veins. However, many patients find them hard to get on and off or are unwilling to use them.
Laser/microwave ablation – can often be used instead to replace stripping of the main vein feeding the varicosities provided that this vein is not too tortuous. It does not remove the varicosities which may need additional treatment. It occasionally fails to work and can rarely cause burns.
Foam sclerotherapy – injections can be used instead unless your veins are very large (>1 cm). It is an outpatient treatment not requiring anaesthetic but may need more than one visit to complete the treatment. Remote thrombosis is a possible complication but very rare and injections also occasionally fail to work.
Serious or frequently occurring risks: no vein treatment is completely safe but serious complications occur in less than 1% of patients. Similarly, none is guaranteed to give a long-term successful result, recurrent varicose veins are common after all treatments. Deep vein thrombosis (DVT) is uncommon (0.5-1% in all treatments) as the operation usually takes under an hour and you are up and about quickly but extra precautions (support stockings, calf massage in theatre and heparin injections) can be taken for patients at higher risk. Around 1 in 10 of those who develop a DVT then get clots in the lungs (pulmonary embolism or PE), only 1 in 10 again of these are dangerous or life-threatening but this is why we take extra precautions for some. Surgery sometimes leaves unsightly scars or thread veins, always causes much bruising after stripping and soreness. There may be numbness around the scars on your leg(s) because skin nerves in the area are cut during the surgery or caught up in the healing scar. This can cause chronic discomfort for around 1 in 50. If the main feeding vein is behind your knee ,an important nerve controlling pulling up of the toes and foot can be injured, resulting in a dropping foot, it is rare(1 in 500). Bleeding after this surgery is unusual (5%) but can occur. Blood (haematoma) or tissue fluid (seroma) sometimes collect under a wound and an occasion may need to be surgically removed to make you more comfortable. Whilst all fresh wounds are red and sore at first, occasionally this may worsen rather improve and can indicate a wound infection requiring prompt review by a doctor and antibiotics. Such wounds may need surgery. Up to 5% of patients are unable to pass urine immediately after the repair. This “retention of urine” is most likely in older patients or men with prostate problems. A tube (catheter) is inserted temporarily into the bladder under local anaesthetic to relieve this. All major operations carry general risks, including heart problems. Some requiring this surgery are older or already have a background of heart disease. The risk of heart attack is very low in vein surgery. It may take up to a month to fully recover from the surgery and you are advised not to drive for a full two weeks afterwards. Modern general anaesthetics are generally very safe and you will have the opportunity to discuss this in detail with your Anaesthetist. Commoner side effects(1 in 10-100) include: nausea or vomiting, sore throat, dizziness, blurred vision, headache, itching, bruising and soreness, pain during drug injection, confusion or memory loss, aches, pains and backache. Uncommon problems (1 in 1000) include: chest infection, muscle pains, slow breathing, damage to teeth, lips or tongue or worsening of an existing medical condition. Rare complications (1 in 10,000-100,000) include damage to the eyes, serious allergy to drugs, nerve damage, awareness during surgery, equipment failure and death.
Any extra procedures which may become necessary during the operation:
- Blood transfusion is not routinely needed unless you are already anaemic but transfusions can result in severe allergic reactions or infections despite careful screening of the blood for you
- Photographs and images are not a usual part of this operation but if we want them for teaching or research purposes, we would always ask you special permission.
- Other procedures except where listed above, are not often required during this operation unless planned in advance. The problems listed above, such as bleeding, infections or fluid collections can lead to additional procedures as described.