A García-Altés1, S Peiró. 1. Fundación Instituto de Investigación en Servicios de Salud, Barcelona, Spain. annagarcia@post.harvard.edu
Abstract
OBJECTIVE: Greater saphenous vein harvest for coronary and lower extremity bypass requires the longest incision of any surgical procedure. Endoscopic vein harvest allows better results in some clinical variables compared to open harvesting techniques. The objective of this study is to present the results of a systematic review of the scientific evidence about the efficiency of endoscopic saphenous vein harvest. METHODS: We performed a systematic review in the bibliographical databases Pubmed, National Health Service Economic Evaluation Database, and NHS Health Technology Assessment Database. The search strategy was "endoscopic AND harvesting", in the period January 1970-December 2009. RESULTS: We identified only 3 economic evaluation studies, 2 cost analyses with some methodological limitations, and 1 cost-utility analysis. All of them suggest lower hospital costs for endoscopic harvesting. CONCLUSIONS: Available evidence does not allow recommendations to be made based on the efficiency of endoscopic saphenous vein harvest, although it suggests lower costs for endoscopic harvesting. More scientific evidence about the long-term efficacy and the effectiveness of this technique is necessary, with studies measuring final outcomes, and carrying out complete and rigorous economic evaluations.
OBJECTIVE: Greater saphenous vein harvest for coronary and lower extremity bypass requires the longest incision of any surgical procedure. Endoscopic vein harvest allows better results in some clinical variables compared to open harvesting techniques. The objective of this study is to present the results of a systematic review of the scientific evidence about the efficiency of endoscopic saphenous vein harvest. METHODS: We performed a systematic review in the bibliographical databases Pubmed, National Health Service Economic Evaluation Database, and NHS Health Technology Assessment Database. The search strategy was "endoscopic AND harvesting", in the period January 1970-December 2009. RESULTS: We identified only 3 economic evaluation studies, 2 cost analyses with some methodological limitations, and 1 cost-utility analysis. All of them suggest lower hospital costs for endoscopic harvesting. CONCLUSIONS: Available evidence does not allow recommendations to be made based on the efficiency of endoscopic saphenous vein harvest, although it suggests lower costs for endoscopic harvesting. More scientific evidence about the long-term efficacy and the effectiveness of this technique is necessary, with studies measuring final outcomes, and carrying out complete and rigorous economic evaluations.
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: Bhuvaneswari Krishnamoorthy; William R Critchley; Rajamiyer V Venkateswaran; James Barnard; Ann Caress; James E Fildes; Nizar Yonan Journal: J Cardiothorac Surg Date: 2016-04-08 Impact factor: 1.637