Crossektomie und Stripping vs. endothermische Ablation der V. saphena magna: Was können wir aus aktuellen Langzeitanalysen lernen?

K. Rass

doi:10.12687/phleb2436-5-2018

Phlebologie, Table of Contents

Phlebologie 2018; 47(05): 265-271
DOI: 10.12687/phleb2436-5-2018

Originalarbeit – Original article

Georg Thieme Verlag KG Stuttgart · New York

Crossektomie und Stripping vs. endothermische Ablation der V. saphena magna: Was können wir aus aktuellen Langzeitanalysen lernen?

Article in several languages: deutsch | English

K. Rass

¹Zentrum für Venen und periphere Arterien, Eifelklinik St. Brigida, Simmerath

› Author Affiliations

Abstract

Zusammenfassung

Hintergrund: Die Therapie der Stammvarikose erfolgt weltweit mit unterschiedlicher Präferenz endovenös, überwiegend thermoablativ, oder offen-chirurgisch. Aktuell liegt jedoch eine Evidenz aus Langzeitstudien (Nachbeobachtungszeit ≥ 5 Jahre) vor, die eine erneute Betrachtung der Wertigkeit der Therapieverfahren notwendig macht. Methoden: Systematische Literaturrecherche zu Langzeitstudien, in denen endovenös thermische Ablationsverfahren mit Crossektomie und Stripping der V. saphena magna verglichen werden. Deskriptive Auswertung der Ergebnisse. Ergebnisse: Langzeitstudien liegen nahezu ausschließlich für den Vergleich mit endovenöser Laserablation und Lichtwellenleitern der 1. Generation (810–980 nm) vor. Während hinsichtlich der Krankheitsschwere und der postoperativen Lebensqualität keine Unterschiede zu beobachten sind, ist die Rate duplexsonographischer und klinischer Crossenrezidive nach Crossektomie signifikant geringer. Schlussfolgerungen: Valide Langzeitstudien zu den heute überwiegend verwendeten endothermischen Ablationstechniken im Vergleich zur offenen Operation fehlen, sind aber angesichts der Befunde aus Studien mit Lasern der 1. Generation dringend geboten.

Schlüsselwörter

Crossektomie/Stripping - Endothermische Ablation - randomisierte kontrollierte Studien - Rezidiv

Full Text

References

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