OBJECTIVES: Our objectives were (1) to determine whether minimally invasive endoscopic harvesting of the saphenous vein reduces morbidity due to postoperative wound infection and pain with improved cosmetic results and mobilization as compared with the conventional technique and (2) to compare the histologic properties of the saphenous veins harvested conventionally and endoscopically. METHODS:One hundred forty-four patients undergoing coronary artery bypass grafting were randomized to have vein harvesting performed by either the conventional (n = 72) or an endoscopic (n = 72) minimally invasive technique. RESULTS:Vein harvest time (open leg wound time) was significantly reduced in the endoscopic group (27.6 vs 64.4 minutes; P <.0001). The rate of leg wound infection was significantly reduced in the endoscopic group (4.3%) as compared with the conventional group (24.6%), a relative risk reduction of 83% (95% confidence interval: 36%-129%; P =.0006). The majority of infections (84.2%) occurred after hospital discharge. Postoperative leg pain, mobilization, and overall patient satisfaction were also significantly improved in the endoscopic group. Double blinded histologic assessment of harvested vein (n = 28) showed no evidence of any clinically important significant damage to the specimens in either group. CONCLUSIONS: In this prospective randomized trial, endoscopic harvesting of the saphenous vein significantly reduced postoperative leg wound complications, including infection, and improved patient satisfaction as compared with the conventional harvesting technique. There were no significant histologic differences between the conventional and endoscopically harvested saphenous veins.
RCT Entities:
OBJECTIVES: Our objectives were (1) to determine whether minimally invasive endoscopic harvesting of the saphenous vein reduces morbidity due to postoperative wound infection and pain with improved cosmetic results and mobilization as compared with the conventional technique and (2) to compare the histologic properties of the saphenous veins harvested conventionally and endoscopically. METHODS: One hundred forty-four patients undergoing coronary artery bypass grafting were randomized to have vein harvesting performed by either the conventional (n = 72) or an endoscopic (n = 72) minimally invasive technique. RESULTS: Vein harvest time (open leg wound time) was significantly reduced in the endoscopic group (27.6 vs 64.4 minutes; P <.0001). The rate of leg wound infection was significantly reduced in the endoscopic group (4.3%) as compared with the conventional group (24.6%), a relative risk reduction of 83% (95% confidence interval: 36%-129%; P =.0006). The majority of infections (84.2%) occurred after hospital discharge. Postoperative leg pain, mobilization, and overall patient satisfaction were also significantly improved in the endoscopic group. Double blinded histologic assessment of harvested vein (n = 28) showed no evidence of any clinically important significant damage to the specimens in either group. CONCLUSIONS: In this prospective randomized trial, endoscopic harvesting of the saphenous vein significantly reduced postoperative leg wound complications, including infection, and improved patient satisfaction as compared with the conventional harvesting technique. There were no significant histologic differences between the conventional and endoscopically harvested saphenous veins.
Authors: Brian C Gulack; Katherine A Kirkwood; Wei Shi; Peter K Smith; John H Alexander; Sandra G Burks; Annetine C Gelijns; Vinod H Thourani; Daniel Bell; Ann Greenberg; Seth D Goldfarb; Mary Lou Mayer; Michael E Bowdish Journal: J Thorac Cardiovasc Surg Date: 2017-12-06 Impact factor: 5.209
Authors: Emile N Brown; Nicholas S Burris; Junyan Gu; Zachary N Kon; Patrick Laird; Seeta Kallam; Cha-Min Tang; Joseph M Schmitt; Robert S Poston Journal: J Biomed Opt Date: 2007 Sep-Oct Impact factor: 3.170
Authors: Sean van Diepen; J Matthew Brennan; Gail E Hafley; Eric M Reyes; Keith B Allen; T Bruce Ferguson; Eric D Peterson; Judson B Williams; C Michael Gibson; Michael J Mack; Nicholas T Kouchoukos; John H Alexander; Renato D Lopes Journal: Ann Surg Date: 2014-08 Impact factor: 12.969
Authors: Emile N Brown; Zachary N Kon; Richard Tran; Nicholas S Burris; Junyen Gu; Patrick Laird; Philip S Brazio; Seeta Kallam; Kimberly Schwartz; Lisa Bechtel; Ashish Joshi; Shaosong Zhang; Robert S Poston Journal: J Thorac Cardiovasc Surg Date: 2007-09-29 Impact factor: 5.209