Endoscopic versus traditional saphenous vein harvesting: a prospective, randomized trial.
BACKGROUND
Saphenous vein harvested with a traditional longitudinal technique often results in leg wound complications. An alternative endoscopic harvest technique may decrease these complications.


METHODS
One hundred twelve patients scheduled for elective coronary artery bypass grafting were prospectively randomized to have vein harvested using either an endoscopic (group A, n = 54) or traditional technique (group B, n = 58). Groups A and B, respectively, were similar with regard to length of vein harvested (41 +/- 8 cm versus 40 +/- 14 cm), bypasses done (4.1 +/- 1.1 versus 4.2 +/- 1.4), age, preoperative risk stratification, and risks for wound complication (diabetes, sex, obesity, preoperative anemia, hypoalbuminemia, and peripheral vascular disease).


RESULTS
Leg wound complications were significantly (p < or = 0.02) reduced in group A (4% [2 of 51] versus 19% [11 of 58]). Univariate analysis identified traditional incision (p < or = 0.02) and diabetes (p < or = 0.05) as wound complication risk factors. Multiple logistic regression analysis identified only the traditional harvest technique as a risk factor for leg wound complications with no significant interaction between harvest technique and any preoperative risk factor (p < or = 0.03). Harvest rate (0.9 +/- 0.4 cm/min versus 1.2 +/- 0.5 cm/min) was slower for group A (p < or = 0.02) and conversion from endoscopic to a traditional harvest occurred in 5.6% (3 of 54) of patients.


CONCLUSIONS
In a prospective, randomized trial, saphenous vein harvested endoscopically was associated with fewer wound complications than the traditional longitudinal method.
Allen
K B
KB
Department of Cardiovascular and Thoracic Surgery, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana, USA.
Griffith
G L
GL
Heimansohn
D A
DA
Robison
R J
RJ
Matheny
R G
RG
Schier
J J
JJ
Fitzgerald
E B
EB
Shaar
C J
CJ
D000367:Age Factors; D000704:Analysis of Variance; D000740:Anemia / Q000150:complications; D001026:Coronary Artery Bypass; D048909:Diabetes Complications; D004487:Edema / Q000209:etiology; D017558:Elective Surgical Procedures; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010149:Postoperative Pain / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000150:complications; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery*; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors
D012709:Serum Albumin