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Moderne Aspekte der Phlebochirurgie

Modern aspects in varicose vein surgery

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Zusammenfassung

Etwa jeder 3. Erwachsene in Deutschland weist ein behandlungsbedürftiges Krampfaderleiden auf. Die konventionelle Varizenchirurgie mit Crossektomie und Stripping als Standardverfahren der Stammveneninsuffizienz ist mit einer hohen Rezidivrate behaftet. Innovative endovasale Verfahren, die den Anspruch auf minimale Invasivität erheben, wurden in den vergangenen 5 Jahren etabliert: Radiowellentherapie, endovenöse Lasertherapie und ultraschallgesteuerte Schaumsklerotherapie. Die Therapieergebnisse sind im Hinblick auf Rezidivhäufigkeit, kosmetisches Resultat und Rekonvaleszenz dem Crossektomie-Verfahren mindestens gleichwertig. Evidenzbasierte prospektive Studien an größeren Patientenkollektiven, die die interventionellen Verfahren mit der konventionellen Operation vergleichen, liegen bislang nicht vor. Im vorliegenden Beitrag werden die aktuellen Entwicklungen der Varizenchirurgie dargestellt und die Grundlagen, Effektivitäts- und Nebenwirkungsprofile der endovasalen Therapieverfahren erläutert.

Abstract

In Germany almost every third adult suffers from varicose veins requiring treatment. Conventional varicose vein surgery by high ligation and stripping is widely accepted as standard therapy for saphenous vein insufficiency, although associated with a high frequency of recurrent varicosities. Innovative endovascular procedures laying claim to be minimally invasive have been implemented over the last five years: endovenous radiofrequency obliteration, endovenous laser treatment and ultrasound-guided sclerotherapy with foam. The early treatment outcomes are promising in regard to recurrent varicose veins, cosmetic results and convalescence. Evidence-based prospective trials with large numbers of participants comparing the interventional procedures with high ligation and stripping are still missing. This report delineates current developments in varicose vein surgery and provides information on principles, effectiveness and side effect profiles of endovascular therapy procedures.

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  1. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg

    K. Rass

  2. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, 66421, Homburg

    K. Rass

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Rass, K. Moderne Aspekte der Phlebochirurgie. Hautarzt 56, 448–456 (2005). https://doi.org/10.1007/s00105-005-0931-8

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  • DOI: https://doi.org/10.1007/s00105-005-0931-8

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