Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques.
BACKGROUND
The differences in hand functionality after harvesting the radial artery for coronary artery bypass grafting (CABG) in an endoscopic technique relative to open technique are unclear.


METHODS
One hundred and sixty-four patients who had CABG and their non dominant hand radial artery was harvested either in an open technique (n = 92) or in an endoscopic technique (n = 72) in a period of 9.8 +/- 3.5 months after the operation were studied. Surgical technique was surgeon specific. Patients were asked either five questions (endoscopic group), or six questions (open group), to assess how radial artery harvesting affected them.


RESULTS
Significantly more patients in the open group experienced significant limitations in their work and regular daily activities (12% versus 0%, p = 0.02), social activities (13% versus 0%, p = 0.005), and experienced significant pain (8% versus 0%, p = 0.04) compared with the endoscopic group. More patients in the open group complained that their arm incision disturb them (24% versus 10%, p = 0.01). Forty-two patients (46%) in the open group would prefer smaller incision. A "limitation score" variable was created from the first four questions to reflect overall functionality. Severe limitation was present in 3% of the open group versus 0% in the endoscopic group (p = 0.04). Female sex and open harvesting technique were found to be independently associated with higher limitation score.


CONCLUSIONS
After a mean of 9.8 months after surgery, patients reports good overall upper-limb function. However, more patients in the open technique had significant disabilities and dissatisfaction.
Medalion
Benjamin
B
Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, 39 Jabotinsky Street, Petach Tikva, 49100, Israel. benjamin2@clalit.org.il
Fuks
Avraham
A
Sharoni
Erez
E
Stamler
Alon
A
Snir
Eitan
E
Vidne
Bernardo
B
Porat
Eyal
E
D000368:Aged; D015897:Comorbidity; D001026:Coronary Artery Bypass; D048909:Diabetes Complications / Q000453:epidemiology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005542:Forearm / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology; D010292:Paresthesia / Q000453:epidemiology / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D017534:Radial Artery / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*