Postoperative and midterm outcomes of minimally invasive and endoscopic great saphenous vein harvesting for coronary artery bypass grafting - a prospective analysis.
BACKGROUND
We sought to determine whether the postoperative and midterm outcomes of minimally invasive and endoscopic great saphenous vein harvesting are comparable.


METHODS
From February 2004 to September 2006, 120 patients underwent minimally invasive vein harvesting, and subsequently 150 patients had endoscopic vein harvesting for CABG. Patients were evaluated prospectively for wound-healing disturbances, residual leg oedema, pain intensity and saphenous neuropathy on the 7th postoperative day and after 3 months.


RESULTS
Both harvesting techniques were associated with a low incidence of wound-healing disturbances; nevertheless, minimally invasive vein harvesting was associated with a significantly higher incidence of residual oedema (28 % vs. 13 %; P < 0.05), (19 % vs. 6 %; P < 0.001), pain (20 % vs. 9 %; P < 0.05), (10 % vs. 6 %; P < 0.05), and saphenous neuropathy (23 % vs. 7 %; P < 0.001) (14 % vs. 3 %; P < 0.001) during follow-up on the 7th postoperative day as well as 3 months after surgery, respectively. Mean harvesting time (40.6 +/- 15.5 vs. 43.9 +/- 10.2 min; P = 0.09), conversion rate (3 % vs. 2 %; P = 0.71), and injury per conduit (0.3 +/- 0.2 vs. 0.3 +/- 0.1; P = 0.91) were comparable for both groups.


CONCLUSIONS
Endoscopic vein harvesting seems to be superior to minimally invasive vein harvesting in terms of a significant reduction of residual leg oedema, pain intensity and particularly saphenous neuropathy in the postoperative and midterm follow-up.
Simek
M
M
Department of Cardiac Surgery, University Hospital and Palacky University Faculty of Medicine, Olomouc, Czech Republic. martin.simek@c-mail.cz
Nemec
P
P
Bruk
V
V
Gwozdziewicz
M
M
Fluger
I
I
Langova
K
K
D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D004487:Edema / Q000453:epidemiology / Q000209:etiology; D019723:Endoscopes; D004724:Endoscopy; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology; D017060:Patient Satisfaction; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing