Endoscopic saphenous vein harvesting versus ‘open’ technique. A prospective study

Folliguet, Thierry; Bret, Emmanuel Le; Moneta, Andrea; Musumeci, S; Laborde, F

doi:10.1016/s1010-7940(98)00092-x

Cited by 41 publications

(24 citation statements)

References 8 publications

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“…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).…”

Section: Meta-analysis Of Haematoma 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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Section: Meta-analysis Of Haematoma Resultsmentioning

confidence: 99%

Section: Meta-analysis Of Haematoma Resultsmentioning

confidence: 99%

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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“…A dor foi classificada em intensa, quando necessitava de analgésicos parenterais; moderada: quando era aliviada com analgésicos via oral; leve quando estava presente durante o esforço físico e era aliviada com repouso, não necessitando de medicações e ausente (20) .…”

Section: Dissecção Da Veia Safena Magnaunclassified

Obtenção da veia safena magna através de acesso minimamente invasivo para revascularizações miocárdicas

Tyszka

Fucuda

Tormena

et al. 2001

Rev Bras Cir Cardiovasc

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Tyszka A L, Fucuda L S, Tormena E B, Campos A C L -Obtenção da veia safena magna através de acesso minimamente invasivo para revascularizações miocárdicas. Rev Bras Cir Cardiovasc 2001; 16(2): 105-13. RESUMO: Objetivo: Avaliar a possibilidade de obtenção da veia safena magna através de miniincisões de pele, a sua qualidade e a ocorrência de complicações precoces da ferida operatória.Casuística e Métodos: Foram estudados 46 pacientes, admitidos entre julho e novembro de 1999. Após miniincisões longitudinais de pele a veia safena magna foi identificada e, com auxílio de afastador de lâmina longa e estreita, delicadamente dissecada. Os pacientes foram divididos em 2 grupos na dependência da presença dos fatores de risco: anemia, aterosclerose periférica, obesidade e diabete melito. As feridas operatórias foram observadas quanto às complicações maiores e menores. Amostras da veia foram enviadas para estudo histológico.Resultados: O número médio de incisões foi 2,3, com tamanho médio de 3,5 cm e de todas incisões somadas de 7,3 cm. O tamanho médio da veia foi 34,1 cm, com tempo médio de retirada de 28,7 minutos. Foram observadas complicações menores em 5 (10,8%) pacientes; sendo hematoma local a mais comum (6,5%). Não foram observadas complicações maiores e a ressecção foi sempre possível. Em 2 casos houve lesão macroscópica da veia, sendo possível a sua correção e utilização. O estudo histológico demonstrou preservação da arquitetura tecidual e não evidenciou lesão endotelial significativa.Conclusões: A obtenção da veia safena magna através de miniincisões é possível e resulta em adequado enxerto venoso. A incidência de complicações da ferida é baixa e independente dos fatores de risco. Estes resultados preliminares sugerem que a técnica pode ser aplicada com segurança em pacientes submetidos à revascularização miocárdica, embora os resultados a longo prazo ainda necessitem ser determinados.

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“…The incidence of saphenous vein harvest site infection is reported to be between 1% and 24% in the literature. [3][4][5][6] Very little has been discussed about the morbidities associated with great saphenous vein harvest site infection (GSVHSI) following CABG. These complications very rarely require major surgical intervention, and are disturbing, both to the patient and to the treating surgeon.…”

Section: Introductionmentioning

confidence: 99%

“…51 Now newer techniques utilizing minimally invasive endoscopic harvesting are in vogue and are being used in many centers. 35,[52][53][54] Minimally invasive techniques using endoscopic and nonendoscopic instruments to reduce surgical incisions and improve the visibility of the SV have been in use since 1996. 55 There is a reduction in trauma to tissues, reduction in injuries to the cutaneous vessels, and a reduction in postoperative infections.…”

mentioning

confidence: 99%

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

Siddiqi¹

2016

CWCMR

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Coronary artery bypass grafting is a commonly performed surgery worldwide that gives good results. Great saphenous vein is used as a conduit for bypass in over 95% cases. The harvesting technique has remained unchanged over the years. However, wound complications from harvesting the great saphenous vein by open method can be a major source of postoperative morbidity. With the objective of preventing major complications, identification of risk factors for saphenous vein harvest site infection is important. It is imperative to develop approaches that prevent infection and to allow for early recognition of patients who are at high risk and who may need more watchful monitoring so as to prevent development of wound complications. It is desirable to assess the patient completely, delineate the anatomy of peripheral vessels particularly in a patient with associated peripheral vascular disease, identify the best site to perform the saphenous vein harvest incision, employ a meticulous surgical technique, recognize complications early, and start the recommended treatment without delay. The aim of this paper is to identify the risk factors for saphenous vein harvest site complications and their identification, prevention, and management.

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Endoscopic saphenous vein harvesting versus ‘open’ technique. A prospective study

Abstract: Endoscopic saphenous vein harvesting allows improved aesthetic aspect, less postoperative discomfort, with an increased time in harvesting in the beginning.

Cited by 41 publications

References 8 publications

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

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

Obtenção da veia safena magna através de acesso minimamente invasivo para revascularizações miocárdicas

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

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