Endoscopic Saphenous Vein Harvesting for CABG - a Randomized, Prospective Trial

Schurr, Ulrich; Lachat, Mario; Reuthebuch, Oliver; Kadner, Alexander; Mader, Marius Marc-Daniel; Seiffert, B; Hoerstrup, Simon P.; Zünd, Gregor; Genoni, Michele; Turina, Marko

doi:10.1055/s-2002-32412

Cited by 46 publications

(25 citation statements)

References 9 publications

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“…Nine of the 27 studies included in our meta-analysis mentioned LOS in MIVH versus CVH groups [14,15,18,22,27,28,30,33,36]. The results (Fig.…”

Section: Length Of Stay Resultsmentioning

confidence: 97%

“…Overall, 22 of the studies reported the incidence of post-operative haematoma [4][5][6][15][16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32][33]37], with seven of these showing a statistically significant reduction in the MIVH as compared to the CVH group. Eleven of the studies were randomised [4][5][6][15][16][17][18][19][20][21][22], with metaanalysis of these calculating an incidence of haematoma of 53/676 (8%) in MIVH and 93/610 (15%) in CVH groups, with an odds ratio (OR) of 0.43 and confidence interval (CI) of 0.23-0.79, suggesting that this difference is statistically significant.…”

Section: Meta-analysis Of Haematoma Resultsmentioning

confidence: 99%

“…Eleven of the studies were randomised [4][5][6][15][16][17][18][19][20][21][22], with metaanalysis of these calculating an incidence of haematoma of 53/676 (8%) in MIVH and 93/610 (15%) in CVH groups, with an odds ratio (OR) of 0.43 and confidence interval (CI) of 0.23-0.79, suggesting that this difference is statistically significant. When considering 12 studies that were fully matched for the patient criteria previously mentioned [4][5][6]15,16,18,19,[21][22][23]32,33], these results were reproduced, with an incidence of haematoma of 50/840 (5%) with MIVH as compared to 88/764 (11%) with CVH (OR 0.46, CI 0.23-0.92). The ARR in the MIVH in comparison to the CVH group was calculated to be 0.08 which can be translated in a number of patients needed to treat of 13.…”

Section: Meta-analysis Of Haematoma Resultsmentioning

confidence: 99%

“…Six studies were randomised [5,15,[19][20][21][22], with meta-analysis of these showing a significant reduction in wound drainage between MIVH (7/393Z1%) and CVH groups (29/355Z8%), OR 0.24 (CI 0.11-0.54). Analysis of the seven fully matched studies [5,15,19,[21][22][23]32], demonstrated an incidence of wound drainage of 8/600 (1%) with MIVH versus 36/444 (8%) with CVH, OR 0.20 (CI 0.09-0.43). The ARR in the MIVH in comparison to the CVH group was calculated to be 0.08 which can be translated in a number of patients needed to treat of 13.…”

Section: Meta-analysis Of Wound Drainage Resultsmentioning

confidence: 99%

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Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis

Athanasiou

Aziz

Al‐Ruzzeh

et al. 2004

European Journal of Cardio-Thoracic Surgery

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Minimally invasive great saphenous vein harvest for coronary artery bypass grafting aims to reduce post-operative leg-wound related morbidity. In a meta-analysis of randomised trials we have shown leg wound infection rates to be significantly lower in patients undergoing minimally invasive harvest. This study aims to use meta-analysis to compare the two techniques with regards to non-infective wound healing disturbances (NIWHD) (wound drainage, haematoma, dehiscence, necrosis, need for surgical debridement, and seroma formation). A meta-analysis of all studies published between 1995 and 2002 reporting a comparison between the two techniques was performed. Primary outcomes of interest were the six wound healing disturbances mentioned above and length of hospital stay. Heterogeneity was assessed using graphical exploration and sensitivity analysis with subgroup analysis. Twenty-seven studies published between 1997 and 2002 matched our selection criteria, with a combined total of 4953 subjects, of which 2442(49%) underwent minimally invasive harvest and 2511(51%) underwent conventional surgery. When considering only randomised studies, the total number of non-infective wound disturbances was lower in minimally invasive (4%) as compared to the conventional (13%) group (random effect OR 0.24, CI 0.16-0.38). Similar results were found when only fully matched studies were considered. The absolute risk reduction when comparing the two techniques was calculated to be 0.10, which translates to a number of patients needed to treat of 10. Length of stay was significantly reduced in the minimally invasive group in comparison to the conventional group (random effect weighted mean difference of -1.04, CI -1.92 to -0.16). Our results suggest that NIWHD all reduced with minimally invasive harvest techniques. Despite the limitations of this meta-analysis, we feel we have once again illustrated an important link between minimally invasive great saphenous vein harvest and improved tissue healing when compared to conventional open surgery. This has the potential to reduce wound-related morbidity, infection, post-operative pain, length of hospital stay, and re-admission rate.

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“…Nine of the 27 studies included in our meta-analysis mentioned LOS in MIVH versus CVH groups [14,15,18,22,27,28,30,33,36]. The results (Fig.…”

Section: Length Of Stay Resultsmentioning

confidence: 97%

Section: Meta-analysis Of Haematoma Resultsmentioning

confidence: 99%

Section: Meta-analysis Of Haematoma Resultsmentioning

confidence: 99%

Section: Meta-analysis Of Wound Drainage Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis

Athanasiou

Aziz

Al‐Ruzzeh

et al. 2004

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…Several prospective studies have shown that patients undergoing EVH have significantly less wound pain, fewer complications, fewer mean days until ambulation, a shorter hospital stay, better cosmetic results, and greater overall patient satisfaction [1][2][3][4][5][6]. The outpatient clinic visits for wound complications were significantly fewer after endoscopic than after traditional vein harvest [7].…”

Section: Discussionmentioning

confidence: 99%