A prospective randomized trial of endoscopic versus open saphenous vein harvesting technique for coronary artery bypass graft surgery

Kalra, Sanjay; Aiyer, Palash; Bhardwaj, Minakshi; Grover, Vijay; Gupta, Vijay

doi:10.1007/s12055-016-0432-7

Cited by 3 publications

(7 citation statements)

References 16 publications

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“…The fact that only thigh veins are harvested in EVH group might reduce the wound complications as diabetic vasculopathy being largely a small vessel disease would affect wound healing more below the knees. OVH technique in the thigh was found to be the only risk [3] .The risk factors are similar in both groups of our study. In Our study, EVH is mainly from thigh, however, 10% from leg and 30% extended from the whole lower limb.…”

Section: Discussionsupporting

confidence: 75%

“…There is widespread general acceptance of EVH doubts about its impact on the integrity, quality of the conduit and longterm graft patency [3] . EVH has emerged as minimally invasive technique that reduces wound pain and infection in CABG surgery.…”

Section: Discussionmentioning

confidence: 99%

“…EVH reduces postoperative pain, the incidence of wound complications and length of hospital stay. EVH also eliminates the need for long leg incisions and increases patient satisfaction [3] . Patients undergoing CABG experience wound complications (3%-30%) related to OVH technique.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Endoscopic Versus Open Saphenous Vein Harvesting Technique on Leg Wound Complications

Mubarak¹

2020

Preprint

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Background: EVH has become prevalent in recent years due to its reduced morbidity and increased patient satisfaction. We designed and carried out a prospective study of patients undergoing CABG to compare outcomes of open versus endoscopic harvesting technique for great saphenous vein. Two groups of patients who underwent elective Coronary artery bypass grafting at our hospitals between January 2018 and October 2020 were included. Endoscopic vein harvesting group (50 patients) was performed endoscopic technique compared with Open Vein Harvesting group (50 patients) was performed open surgical incision for harvesting. Both groups were demographically similar and received identical management. Leg wound was evaluated at discharge, 2 weeks, and 4 weeks for evidence of complications. Early outcomes were compared included, infection, gaped wound and re-suture, pain, satisfied cosmetically and mobilization. Results: Endoscopic vein harvesting group had increased harvest time and decreased incision closure time when compared with Open Vein Harvesting. The average hospitalization time was 6.5 ± 2.2 days for Endoscopic vein harvesting group and 9.2 ± 2.9 days for Open Vein Harvesting group. In Endoscopic vein harvesting group, no significant hematomas were observed. In Open Vein Harvesting group, hematomas were detected in 2 patients and were surgically evacuated. In Endoscopic vein harvesting group, edema occurred less frequently. Infection of the incision location did not occur in Endoscopic vein harvesting group. Leg wound complications were significantly reduced in Endoscopic vein harvesting group in comparison with Open Vein Harvesting group. Conclusions: Endoscopic vein harvesting decreases leg wound complications and increases patient’s satisfaction cosmetically.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Effect of Endoscopic Versus Open Saphenous Vein Harvesting Technique on Leg Wound Complications

Mubarak¹

2020

Preprint

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“…EVH reduced the effect of diabetes and obesity on the incidence of wound complications. EVH from the thigh may reduce the wound complications of diabetes because of vasculopathy, which is a small vessel disease, affected wound healing more below the knees [Kalra 2016]. In our study, the site of harvesting did not affect rate of infection, in spite of the high rate of infection in diabetic patients -22% more than non-diabetic 9%.…”

Section: E608mentioning

confidence: 48%

“…EVH is a less invasive technique and associated with 2% to 5% incidence of wound complications. It reduces postoperative pain, small leg incisions, and increases patient satisfaction [Kalra 2016]. OVH technique has an incidence of 3% to 30% wound complication.…”

Section: Introductionmentioning

confidence: 99%

Leg Wound Complications: A Comparison Between Endoscopic and Open Saphenous Vein Harvesting Techniques

Mubarak

Abdeljawad

2021

HSF

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Background: The most common conduit for coronary artery bypass graft (CABG) surgery is saphenous vein graft (SVG). There are two techniques for SVG harvesting: open and endoscopic. Our aim is to evaluate clinical results of endoscopic versus open SVG harvesting. Nowadays, endoscopic vein harvesting (EVH) has become prevalent because of reduced complications with more patient satisfaction. Objective: We designed and performed a prospective randomized cohort study of patients undergoing CABG to compare the results of open versus endoscopic harvesting technique. Methods: Patients who underwent elective CABG at our hospitals were divided into two groups, during the period of January 2019 to March 2021. The EVH group (50 patients) underwent endoscopic technique compared with the open vein harvesting (OVH) group (50 patients) that was underwent open surgical incision for great saphenous vein (GSV) harvesting. The two groups demographically were similar and received identical management. Leg wound was evaluated at discharge, two weeks, and four weeks for evidence of any complications. Early outcomes were recorded, including infection, gaped wound and surgical re-suture, degree of pain, level of cosmetic satisfaction, and early mobilization. Results: In the EVH group, harvesting time increased, and incision closure time decreased in comparison with OVH. The hospital stay was 5.5 ± 2.4 days in the EVH group versus 9.5 ± 2.7 days in the OVH group. Leg wound complications were significantly reduced in the EVH group in comparison with the OVH group. Conclusions: Endoscopic vein harvesting technique reduced leg wound complications. Conveniently, patients also were cosmetically satisfied.

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Saphenous vein harvesting techniques for coronary artery bypass grafting: a systematic review and meta-analysis

Vuong¹,

Elfaituri²,

Eldoadoa³

et al. 2021

Coronary Artery Disease

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The great saphenous vein (GSV) graft remains a frequently used conduit for coronary artery bypass graft (CABG) surgery. The optimal technique for GSV harvesting has been the subject of on-going controversy. We therefore sought to conduct a systematic review and meta-analysis of all available GSV harvesting techniques in CABG. A systematic search of 12 electronic databases was performed to identify all randomized controlled trials (RCTs) of any GSV harvesting technique, including conventional vein harvesting (CVH), no-touch, standard bridging technique (SBT) and endoscopic vein harvesting (EVH) techniques. We investigated safety and long-term efficacy outcomes. All outcomes were analyzed using the frequentist network meta-analysis. A total of 6480 patients from 34 RCTs were included. For safety outcomes, EVH reduced 91% and 77% risk of wound infection compared to no-touch and CVH, respectively. EVH and SBT also significantly reduced the risk of sensibility disorder and postoperative pain. The techniques were not significantly different regarding long-term efficacy outcomes, including mortality, myocardial infarction and graft patency. For GSV harvesting for CABG, EVH techniques are the most favorable, but in case of using an open technique, no-touch is more recommended than CVH. More effective and safer procedures should be investigated for GSV harvesting in CABG.

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A prospective randomized trial of endoscopic versus open saphenous vein harvesting technique for coronary artery bypass graft surgery

Cited by 3 publications

References 16 publications

Effect of Endoscopic Versus Open Saphenous Vein Harvesting Technique on Leg Wound Complications

Effect of Endoscopic Versus Open Saphenous Vein Harvesting Technique on Leg Wound Complications

Leg Wound Complications: A Comparison Between Endoscopic and Open Saphenous Vein Harvesting Techniques

Saphenous vein harvesting techniques for coronary artery bypass grafting: a systematic review and meta-analysis

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