title: Endoscopic versus mini-invasive radial artery graft harvesting for purposes of aortocoronary bypass.
abstract: The aim of the study was to compare three different methods of radial artery harvesting with regard to postoperative complications and perioperative stress of the patient. A total of 60 patients admitted for coronary artery bypass surgery were randomized into three groups. Each patient underwent extraction of radial artery, all performed by a single surgeon. The radial artery was harvested by one of the following three techniques: classical technique (20 patients), mini-invasive technique (20), and endoscopic technique (20). The time required for the graft harvest was greater in the group where the endoscopic technique was used (52.6 ± 11.3 min) than with the mini-invasive (41.5 ± 7.3 min) or the classical (27.8 ± 4.6 min) technique. Postoperative blood loss into drains was higher where the classical technique was used (35.5 ± 9.4 ml) as compared to the mini-invasive (20 ± 5 ml) or the endoscopic (10 ± 7.3 ml) technique. There was no significant difference among the groups in the rate of local neurological complications, contusion of wound edge, edema of the extremity, or wound infection rate. We observed no case of ischemia of the extremity, and a single case of postoperative myocardial ischemia in the group where the classical technique was used. From a clinical point of view, the mini-invasive and the endoscopic approach are comparable, but the latter is more expensive. Both mini-invasive and endoscopic techniques prolong the operation, reduce perioperative blood loss, and require additional training time.
authors.affiliation: 2nd Department of Surgery - Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic. tgrus@seznam.cz
authors.forename: T
authors.initials: T
authors.lastname: Grus
authors.forename: L
authors.initials: L
authors.lastname: Lambert
authors.forename: G
authors.initials: G
authors.lastname: Grusová
authors.forename: V
authors.initials: V
authors.lastname: Rohn
authors.forename: J
authors.initials: J
authors.lastname: Lindner
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D017534:Radial Artery / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods*