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Moderne Varizenchirurgie

Modern varicose vein surgery

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Zusammenfassung

Die Varizenoperation gehört zu den am häufigsten durchgeführten operativen Eingriffen in Deutschland. Neben der klassischen Operation in moderner Technik, die bei überschaubaren Rezidivquoten und guten kosmetischen Ergebnissen als etabliertes Standardverfahren angesehen werden muss, kommen zunehmend endoluminale Therapieverfahren (Radiofrequenzwellentherapie, Lasertherapie) zum Einsatz. Sie bieten dem Patienten geringere postoperative Schmerzen und eine kürzere Rekonvaleszenzzeit gegenüber der klassischen Operation, stehen aufgrund ihrer Anwendungsmöglichkeit (Limitierung durch den Gefäßdurchmesser bzw. die Sondierbarkeit der Vene, fehlende Kostenübernahme durch die gesetzliche Krankenversicherung) jedoch nur einem eingeschränkten Patientenspektrum zur Verfügung. Es bleibt abzuwarten, wie sich diese Verfahren insbesondere bezüglich der Verbesserung der Langzeitlebensqualität und der Rezidivquoten gegenüber der klassischen Operationstechnik darstellen. Eine zusätzliche Therapieoption bietet ein chemisches endoluminales Therapieverfahren, die katheterassistierte Schaumsklerosierung. Sie kann in Einzelfällen als sichere Therapieoption mit insgesamt guten postoperativen Ergebnissen eingesetzt werden, die primären Verschlussquoten sind denen der Operation und der endoluminalen Verfahren jedoch unterlegen.

Abstract

Varicose vein operations belong to the most commonly performed surgical procedures in Germany. Besides the classic operation employing modern technology, which shows manageable recurrence rates with good cosmetic results and must be considered as the established standard therapeutic procedure, endoluminal treatment methods (endovenous radiofrequency therapy, endoluminal laser therapy) have been increasingly used in recent years. The endoluminal treatment methods offer patients reduced post-operative pain and a shorter recovery time compared to traditional surgery. Unfortunately due to limitations caused by vessel diameter and the ability to probe the vessel, they are only available to a limited range of patients. It remains to be seen how these procedures compare to the classical techniques, in particular in regards to improving the long-term quality of life and recurrence rates. A further therapeutic option is chemical endoluminal therapy, catheter-assisted foam sclerotherapy. It can be used as a safe treatment option with good postoperative results in some cases. However, the primary closure rates are inferior to surgery and endoluminal procedures.

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  1. Tabea GmbH & Co.KG, Kösterbergstr. 32, 22587, Hamburg, Deutschland

    G. Bruning & B. Altmann

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  1. G. Bruning
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  2. B. Altmann
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Correspondence to G. Bruning.

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Bruning, G., Altmann, B. Moderne Varizenchirurgie. Hautarzt 62, 347–353 (2011). https://doi.org/10.1007/s00105-010-2085-6

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  • DOI: https://doi.org/10.1007/s00105-010-2085-6

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