Endoscopic vs conventional vein harvesting: a prospective analysis.
Minimally invasive vein harvesting is associated with better leg wound healing and a lower incidence of wound infections. We analyzed our experience in 2 prospectively enrolled groups of non-randomized patients undergoing elective coronary artery bypass grafting. Group 1 was 81 patients who had endoscopic vein harvesting; group 2 was 80 who had conventional open vein harvesting. The time taken for endoscopic harvest (skin incision to skin closure) was significantly less than that for open harvest (51.07 vs 75.94 min). The number of cases to reach a plateau on the learning curve for endoscopic vein harvest was 20 for 2 lengths of vein and 35 for 3 lengths of vein. Significantly more suture repairs per vein were required in group 1 (1.32) than group 2 (0.38). The incidence of wound infection was 1.2% in group 1 vs 8.8% in group 2. Endoscopic vein harvesting is not difficult to learn and it should be preferred over open vein harvest, given its benefits in wound healing.
Vaidyanathan
Karthik R
KR
Frontier Lifeline and Dr. KM Cherian Heart Foundation, International Center for Cardiothoracic and Vascular Diseases, R-30 Ambattur Industrial Estate Road, Chennai 600101, India. rkvdoc@rediffmail.com
Sankar
Madhu N
MN
Cherian
Kotturathu M
KM
D002983:Clinical Competence; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D017558:Elective Surgical Procedures; D004724:Endoscopy / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007858:Learning; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D014680:Veins / Q000637:transplantation; D014945:Wound Healing