title: A comparative analysis of saphenous vein conduit harvesting techniques for coronary artery bypass grafting--standard bridging versus the open technique.
abstract: Coronary artery bypass graft (CABG) surgery involves harvesting the great saphenous vein (GSV) using the traditional open technique (TOT). This can be associated with significant leg morbidity and patient dissatisfaction. Alternatively, the standard bridging technique (SBT) is a minimally invasive procedure of vein retrieval that uses smaller frequent incisions along the length of the leg and may reduce postoperative complications. This study was designed to compare the success of SBT in reducing leg morbidity and increasing patient satisfaction. One hundred patients were recruited into the study and computer randomised into two groups of 50 undergoing SBT or TOT. Leg morbidity and patient satisfaction were analysed by assessment of pain scores, wound development and scar formation. Closure and harvesting time were also compared between the two groups. SBT was associated with better wound development (P<0.001) and a significantly higher patient satisfaction (P<0.001). Leg pain was significantly reduced amongst SBT group at rest and with movement (P<0.001). There was also a reduction in saphenous neuropathy with the use of SBT (P<0.001). No difference in closure or harvesting time was demonstrated (P=0.26 and P=0.23, respectively). This study demonstrates that harvesting the GSV by the minimally invasive SBT reduces postoperative leg morbidity and increases patient satisfaction without the need of costly equipment. SBT represents a safe, effective and financially viable technique for vein harvesting.
authors.affiliation: The Transplant Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, M23 9LT, UK.
authors.forename: Ursalan A
authors.initials: UA
authors.lastname: Khan
authors.forename: Bhuvaneswari
authors.initials: B
authors.lastname: Krishnamoorthy
authors.forename: Osman
authors.initials: O
authors.lastname: Najam
authors.forename: Paul
authors.initials: P
authors.lastname: Waterworth
authors.forename: James E
authors.initials: JE
authors.lastname: Fildes
authors.forename: Nizar
authors.initials: N
authors.lastname: Yonan
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000209:etiology; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D017060:Patient Satisfaction; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000517:prevention & control; D012501:Saphenous Vein / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing