Endoscopic versus open saphenous vein harvest: the effect on postoperative outcomes.
BACKGROUND
Endoscopic vein harvest (EVH) has been promoted as a possible solution to the wound complications, incisional pain, and prolonged convalesce associated with open vein harvesting (OVH). The purpose of this study was to objectively compare the two techniques.


METHODS
One hundred patients were prospectively randomized to EVH or OVH. Primary outcomes were wound complications, pain (Medical Outcomes Study Pain Survey), and general health (SF-12). Secondary outcomes were operative times and patient preferences. Patients were assessed at hospital discharge, 3, and 6 weeks postdischarge.


RESULTS
No significant differences were detected in the primary outcomes: leg infection (p = 0.75), incisional pain (p = 0.74), physical health (p = 0.84), mental health (p = 0.47), and postoperative length of stay (p = 0.74). However, patient preference for EVH was highly significant (p < 0.01).


CONCLUSIONS
EVH does not demonstrate significant differences compared with OVH. This, coupled with higher operating room costs, should limit its use until clinical benefit is shown. However, strong patient preference and demand for EVH overshadow equivocal clinical outcomes.
Hayward
T Z
TZ
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA. haywa001@mc.duke.edu
Hey
L A
LA
Newman
L L
LL
Duhaylongsod
F G
FG
Hayward
K A
KA
Lowe
J E
JE
Smith
P K
PK
D000368:Aged; D001026:Coronary Artery Bypass; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013530:Surgical Wound Infection; D020858:Tissue and Organ Harvesting / Q000379:methods*