Standards bei der Krossektomie und Strippingoperation der V. saphena magna

The classical operative treatment of varicose veins with crossectomy and stripping of the great saphenous vein has been continously developed over the years. Modern treatment concepts are based on the widespread use of duplex sonography and on minimizing surgical trauma, particularly through the use of invaginating stripping methods. The crossectomy aims to completely eliminate the insufficient saphenous vein without leaving a stump and thus to achieve a susteinable separation of the deep venous system from the superficial network. This is achieved better with surgery than with competing endovenous treatment methods. In prospective studies with randomization, surgery performs better than endovenous procedures in preventing groin recurrences; however, this advantage of surgery has not yet been included in international guidelines. Due to the overall lack of evidence, there is a significant need for valid comparative studies in order to be able to determine the actual value of modern variceal surgery in the context of the various treatment options for trunk insufficiency of the great saphenous vein.