Therapie des inguinalen Crossenrezidivs: Ist die offene Re-Crossektomie noch zeitgemäß?

Zusammenfassung

Einleitung Die Rezidivvarikose ist trotz der Entwicklung neuer Verfahren und Operationsstrategien ein relevantes medizinisches Problem. Zur Therapie inguinaler Crossenrezidive (ICR) steht die offene Re-Crossektomie zur Verfügung, die derzeit gegenüber weniger invasiven Verfahren in den Hintergrund tritt.

Methoden Diese Übersichtsarbeit basiert auf aktuell verfügbaren Leitlinien und einer Literaturrecherche bei PubMed zur Frage des Einsatzes und der Effektivität verschiedener Verfahren zur Therapie des ICR.

Ergebnisse Inguinale Re-Crossektomie und Schaumsklerosierung sind uneingeschränkt anwendbar. Die Operation, sofern mit Barrieretechnik kombiniert, scheint langfristig effektiver als die Verödung und ist mit einer hohen Patientenzufriedenheit verbunden. Endovenös thermische Ablationsverfahren können für individuelle Fälle mit geeignetem anatomischem Befund eingesetzt werden. Vergleichende Studien fehlen.

Schlussfolgerung Die offene Re-Crossektomie ist zeitgemäß. Ob der Vorteil der potentiell höheren Effektivität bei der Operation stärker wiegt als die geringere Invasivität der Schaumsklerosierung verbunden mit häufigeren Therapiesitzungen müsste mittels randomisierter kontrollierter Studien geklärt werden.

Schlüsselwörter

Crossenrevision - endovenös thermische Ablation - Rezidivvarikose - Verödung

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