A Comparative Study Between Conventional And Endoscope-assisted Greater Saphenous Vein Harvesting In CABG

Objective To exp lore the value of endoscopic mini-incision greater saphenous vein harvesting for coronary artery bypass operation. Methods A total of 411 patients scheduled for coronary artery bypass operation were given either endoscopic vein harvesting ( EVH Group, n = 50) or open vein harvesting (OVH Group, n =55) , based on patient's willingness. The operation outcomes and incision comp lications were compared between the two groups. Results The incidence of various incision comp lications was significantly lower in the EVH Group (30%,15/50) than in the OVH Group (65% , 36/55) ( x~2=13.180,P=0.000). As compared with the OVH Group, the EVH Group had lower incidences of edema ( 8% vs40%;χ~2 =14.395 , P = 0.000) , paraesthesia ( 8% vs 32.7%; x~2=9.669, P= 0.002) , hematoma ( 4% vs 20%; x~2=5.204 , P=0.023) , incisional liquefaction (6 % vs 21.8%; x~2=5.352 ,P=0.021) and with unbearable pain (6 % vs 20%; x~2=4.442, P=0.035) of the lower extemity. The total operation time were226. 3±28. 5 min in the EVH Group and 224.7±19.2 min in the OVH Group, without significant difference between the two groups(t=0.673, P= 0.502). Early graft failure happened in 1 case in each of the group s, without significant difference between the two group s ( x~2=0.000, P=1.000). The numbers of distal coronary anastomoses were 3. 6±0. 8 in the EVH Group and 3.3±1.0 in the OVH Group, with significant difference (t= 3.049, P=0.002). Conclusions Endoscopic greater saphenous vein harvesting can significantly reduce the morbidity associated with incision comp lications, whereas does not prolong the operative time, increase the incidence of early graft failure, and decrease the number of distal coronary anastomoses.