Postoperative and Midterm Outcomes of Minimally Invasive and Endoscopic Great Saphenous Vein Harvesting for Coronary Artery Bypass Grafting - A Prospective Analysis

Šimek, Martin; Němec, Petr; Bruk, Vilém; Gwozdziewicz, Marek; Fluger, Ivo; Langová, Kateřina

doi:10.1055/s-2007-965325

Cited by 7 publications

(2 citation statements)

References 15 publications

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“…A possible explanation is that saphaenous nerve injury can occur as a result of surgical handling or postoperatively from compression caused by subcutaneous suturing. Relevant literature addressed alternative techniques to avoid this injury (Bonde et al., ; Allen et al., ; Simek et al., ).…”

Section: Discussionmentioning

confidence: 99%

Persistent Postoperative Pain after Cardiac Surgery: Incidence, Characterization, Associated Factors and its impact in Quality of Life

Guimarães‐Pereira

Farinha

Azevedo

et al. 2016

European Journal of Pain

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This is the first study comprehensively describing PPP after CS and identifying NP in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower QoL, which deserves the attention of health care professionals in order to improve prevention, assessment and treatment of these patients. WHAT DOES THIS STUDY ADD?: This study comprehensively describes persistent postoperative pain (PPP) after cardiac surgery (CS) and identifies neuropathic pain (NP) in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower quality of life.

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Section: Discussionmentioning

confidence: 99%

Persistent Postoperative Pain after Cardiac Surgery: Incidence, Characterization, Associated Factors and its impact in Quality of Life

Guimarães‐Pereira

Farinha

Azevedo

et al. 2016

European Journal of Pain

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“…The higher percentage of complications in the OVH than the EVH group was accounted for by more frequent early lymphatic drainage. Thus, in the EVH group, according to the findings of previous studies, lymphatic drainage was observed in approximately 10–12 % of patients [ 18 ]. However, in the present study, it was only observed in 4.5 % of patients.…”

Section: Discussionmentioning

confidence: 84%

Comparative results of endoscopic and open methods of vein harvesting for coronary artery bypass grafting: a prospective randomized parallel-group trial

Cherniavsky

Volkov

Lavrenyuk

et al. 2015

J Cardiothorac Surg

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BackgroundWe compared wound complications between endoscopic and open great saphenous vein harvesting for coronary artery bypass surgery.MethodsA total of 228 consecutive patients were prospectively randomized into two groups: open vein harvesting (OVH), 115 patients; and endoscopic vein harvesting (EVH), 113 patients. Each group was assessed for post-operative wound complications, pain intensity, and neuropathy in the early post-surgical period. Lymphoscintigraphy of the lower limbs as well as morphological studies of vein walls using light and electron scanning microscopy were performed.ResultsVein harvesting time was shorter for EVH than OVH: 31.8 ± 6.2 min and 40.3 ± 15.8 min, respectively (p < 0.01). There were fewer complications after vein harvesting in the EVH group (11.5 %) than in the OVH group (44.4 %) (р = 0.001). Multivariate analysis showed that diabetes mellitus was the only risk factor for post-surgical complications after OVH (odds ratio = 3.95 %; 95 % confidence interval 1.03–8.6). Lymphoscintigraphic data in the EVH group did not demonstrate considerable disturbances in lymph drainage after surgery. In the OVH group, the accumulation of radiopharmaceutical drugs in the lymphatic nodes reduced two-fold (р ≤ 0.001). Histological evaluation of vein samples did not show considerable damage to the vein wall in either group.ConclusionsUsing electron microscopy of vein fragments, this study demonstrated that EVH reduces wound complications and provides good-quality conduits.

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Postoperative and mid-term wound disturbance outcomes of minimally invasive saphenous vein harvest using the VEGA system

Šimek

Němec

2007

Heart Vessels

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Great saphenous vein harvest is associated with a significant risk of impaired wound healing. The purpose of this study was to determine efficacy of one system designed for minimally invasive vein harvest (MIVH) and to assess postoperative and mid-term wound-healing disturbances. From February 2004 to June 2005, great saphenous harvest for coronary artery bypass grafting (CABG) was performed in a group of 120 consecutive patients employing the VEGA system (B/Braun-Aesculap, Tuttlingen, Germany). Patients were evaluated on 7th postoperative day, at the 3-month and 1-year follow-up for wound healing disturbances, residual leg edema, and saphenous neuropathy. The mean age was 67.3 years, male patients dominated (70%), and the leading procedure was CABG (83%). The mean number of harvested venous grafts was 1.9 +/- 1.2 and the mean number of skin incisions was 3.7 +/- 2.2. The mean total vein harvesting time was 40.2 +/- 16.8 minutes. Satisfactory healing was achieved in 98% patients on 7th postoperative day and at the 3-month follow-up all wounds were completely healed. Saphenous neuralgia remained a significant cause of morbidity, although its incidence decreased from 25% presented on 7th postoperative day to 8% presented at 1-year follow-up. Likewise, the incidence of leg edema decreased from 34% on the 7th postoperative day to 7% at 1-year follow-up. Minimally invasive vein harvest is a safe method associated with a significant reduction of wound disturbances. The VEGA system appears to be suitable and effective equipment for MIVH. Nevertheless, residual edema and mainly saphenous neuropathy represent a relatively frequent cause of patient morbidity at the postoperative and mid-term follow-up.

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Postoperative and Midterm Outcomes of Minimally Invasive and Endoscopic Great Saphenous Vein Harvesting for Coronary Artery Bypass Grafting - A Prospective Analysis

Abstract: Endoscopic vein harvesting seems to be superior to minimally invasive vein harvesting in terms of a significant reduction of residual leg oedema, pain intensity and particularly saphenous neuropathy in the postoperative and midterm follow-up.

Cited by 7 publications

References 15 publications

Persistent Postoperative Pain after Cardiac Surgery: Incidence, Characterization, Associated Factors and its impact in Quality of Life

Persistent Postoperative Pain after Cardiac Surgery: Incidence, Characterization, Associated Factors and its impact in Quality of Life

Comparative results of endoscopic and open methods of vein harvesting for coronary artery bypass grafting: a prospective randomized parallel-group trial

Postoperative and mid-term wound disturbance outcomes of minimally invasive saphenous vein harvest using the VEGA system

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