A meta-analysis of minimally invasive versus traditional open vein harvest technique for coronary artery bypass graft surgery.
The long saphenous vein remains the most commonly used conduit in coronary artery bypass surgery. Vein harvest is a critical component of this operation with significant morbidity associated with large leg wounds from open techniques. Here, we analyse the available literature comparing minimally invasive techniques vs. the traditional open method for vein harvest. A systematic literature search of Medline, Embase and Cochrane databases was performed using the following terms; 'saphenous vein', 'coronary artery bypass', 'tissue and organ harvesting' and 'endoscopic'. Relevant papers were then analysed using Statsdirect software. There was significantly reduced leg wound infection, leg wound haematoma and postoperative pain in the minimally invasive group. There was no statistical difference between the groups for vein harvest time, length of hospital stay and incidence of vein injury. There was a significantly reduced long-term graft patency in veins harvested by a minimally invasive technique. The results of this meta-analysis demonstrate the operative advantages of minimally invasive techniques for the purposes of vein harvest in coronary artery bypass surgery. However, further studies are required to look at long-term graft patency following minimally invasive vein harvest as this remains a major concern.
Markar
Sheraz R
SR
Department of Cardiothoracic Surgery, Papworth Hospital, Papworth Everard, Cambridge, UK.
Kutty
Ramesh
R
Edmonds
Lyn
L
Sadat
Umar
U
Nair
Sukumaran
S
D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010149:Postoperative Pain / Q000209:etiology; D012501:Saphenous Vein / Q000637:transplantation*; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures