Is it safe to perform endoscopic vein harvest?

Interactive Cardiovascular and Thoracic Surgery
Charlene TennysonMarco Scarci

Abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in [patients undergoing coronary revascularisation] is [endoscopic vein harvest] superior to [open harvest] in improving [clinical outcome and cost effectiveness]? Altogether >166 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. All papers agree that endoscopic vein harvesting (EVH) reduces the level of postoperative pain (pain score for EVH=0.52+/-0.95; open technique=1.02+/-1.51; P=0.03) and wound complications (range from 3 to 7.4% for EVH and 13 to 19.4% for conventional technique). These clinical benefits were associated with a high level of patient satisfaction. On average, four papers found that the length of hospital stay was reduced in the EVH group [weighted mean difference (WMD) -1.04 to -0.85; confidence interval (CI) -1.92 to -0.16; P=0.02]. The overall occlusion rates of venous grafts after six months were 21.7% for EVH and 17.6% for open technique. There were no differences in the six months occlusion and disease rates between EVH and conventional vein harvest (CVH), as determined by means of univariate analysis (P=0.584). Ho...Continue Reading

References

Nov 3, 2004·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Thanos AthanasiouBrian Glenville
Mar 5, 2005·The Journal of Thoracic and Cardiovascular Surgery·Kwok L YunSiavosh Khonsari
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Joel DunningKevin Mackway-Jones
Apr 1, 2008·The Journal of Thoracic and Cardiovascular Surgery·Christopher RaoThanos Athanasiou
Jul 17, 2009·The New England Journal of Medicine·Renato D LopesJohn H Alexander
Jan 1, 2005·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Davy ChengRichard Vitali
Jan 1, 2006·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Nicholas BurrisRobert Poston

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Citations

Mar 22, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Priya SastryStephen R Large
Jun 2, 2011·Future Cardiology·Donald S Likosky, Lawrence J Dacey
Jun 9, 2015·Scandinavian Cardiovascular Journal : SCJ·Jan J AndreasenSvend E Jensen
Jun 17, 2015·The Korean Journal of Thoracic and Cardiovascular Surgery·Do Yeon KimJoonkyu Kang
Mar 26, 2010·Interactive Cardiovascular and Thoracic Surgery·Peter MattFriedrich Eckstein
Mar 26, 2010·Interactive Cardiovascular and Thoracic Surgery·Jamshid H KarimovMattia Glauber

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