Surgical treatment of varicosis

摘要

Is complete crossectomy, the dogma of classical varicose vein surgery necessary or not? The endovenous-thermic procedure and sclerotherapy both have in common that the interruption of the saphenous veins near to the femoral vein with parallel ligaturing and severing of the side branches can no longer be considered suitable. The data on classical varicose vein surgery is unsatisfactory to poor and also inferior to the data on the endovenous procedure. This lies partly in the fact that results from the older literature can barely be considered valid for the state of development for classical varicose vein surgery because the technique has developed further in recent years. Furthermore, data from studies on long-term outcome of the surgical treatment of varicosis are limited. Large multicenter register studies which could determine the state-of-the-art are lacking. Independent of the outcome of the argument over methods, the classical varicose vein surgery will endure because even in the future a possibility must exist for therapy resistant and recurrent cases, which are not accessible for new techniques, to be treated. The question of primary treatment remains, however, contentious. In order to clarify this question a fundamental stock taking will be necessary.