Endoscopic saphenous vein harvesting: Initial experience and learning curve
Background. Saphenous vein remains an elective conduit for up to 85% of coronary bypass operations. It is obtained through one or numerous skin incisions, with a reported morbidity varying from 5% to 25%. The endoscopic vein harvesting (EVH) technique was developed to minimize this morbidity and to...
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2000
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| Acceso en línea: | https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00034975_v70_n3_p1086_Vrancic http://hdl.handle.net/20.500.12110/paper_00034975_v70_n3_p1086_Vrancic |
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paper:paper_00034975_v70_n3_p1086_Vrancic2023-06-08T14:24:33Z Endoscopic saphenous vein harvesting: Initial experience and learning curve adult aged conference paper coronary artery bypass graft device endoscopic surgery experience female hematoma human infection learning major clinical study male morbidity priority journal saphenous vein skin incision skin necrosis surgical technique vascular access vein bypass Adult Aged Aged, 80 and over Coronary Artery Bypass Diabetes Mellitus Endoscopy Feasibility Studies Female Human Male Middle Age Obesity Saphenous Vein Surgical Procedures, Minimally Invasive Vascular Diseases Background. Saphenous vein remains an elective conduit for up to 85% of coronary bypass operations. It is obtained through one or numerous skin incisions, with a reported morbidity varying from 5% to 25%. The endoscopic vein harvesting (EVH) technique was developed to minimize this morbidity and to improve clinical outcomes. The aim of this study was to review the feasibility of this method, its learning curve, and changing results in a group without previous experience in this procedure. Methods. Between July 1998 and October 1999, 179 patients for coronary artery bypass grafting underwent EVH (Vasoview Guidant, USA 'double access' and Uniport), by two operators. Results were reported based on time of harvesting, length of conduits, technical details, and clinical outcomes, and divided into six groups of 30 consecutive patients each. Results. Patient demographics were as follows: 86.03% were male, aged 64.3 ± 9.12 years (range, 43 to 92 years), with diabetes mellitus in 28.49%, obesity in 18.43%, and vascular disease in 11.17%. The EVH method was limited to the thigh in 77.65% of cases and extended to the leg in 22.35%. Patients received an average of 2.45 ± 0.58 incisions and obtained conduits had a mean length of 34.96 ± 9.65 cm (range, 15 to 70 cm). The number of venous bypasses per patient was 1.30 ± 0.59. Mean time of EVH was 47.24 ± 19.84 minutes (range, 15 to 120), with a length-time index of 0.85 ± 0.36. Primary success was achieved in 95.54%, with crossover to open technique in 4.46%. General morbidity was 8.9%, with hematoma in 1.11%, skin necrosis in 1.11%, infection in 6.7%, and readmission in 1.11%. Conclusions. Endoscopic vein harvesting is a feasible and reproductible method, with a typical learning curve, acceptable morbidity, and unquestionable benefits for coronary artery bypass graft patients.(C) 2000 by The Society of Thoracic Surgeons. 2000 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00034975_v70_n3_p1086_Vrancic http://hdl.handle.net/20.500.12110/paper_00034975_v70_n3_p1086_Vrancic |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
adult aged conference paper coronary artery bypass graft device endoscopic surgery experience female hematoma human infection learning major clinical study male morbidity priority journal saphenous vein skin incision skin necrosis surgical technique vascular access vein bypass Adult Aged Aged, 80 and over Coronary Artery Bypass Diabetes Mellitus Endoscopy Feasibility Studies Female Human Male Middle Age Obesity Saphenous Vein Surgical Procedures, Minimally Invasive Vascular Diseases |
| spellingShingle |
adult aged conference paper coronary artery bypass graft device endoscopic surgery experience female hematoma human infection learning major clinical study male morbidity priority journal saphenous vein skin incision skin necrosis surgical technique vascular access vein bypass Adult Aged Aged, 80 and over Coronary Artery Bypass Diabetes Mellitus Endoscopy Feasibility Studies Female Human Male Middle Age Obesity Saphenous Vein Surgical Procedures, Minimally Invasive Vascular Diseases Endoscopic saphenous vein harvesting: Initial experience and learning curve |
| topic_facet |
adult aged conference paper coronary artery bypass graft device endoscopic surgery experience female hematoma human infection learning major clinical study male morbidity priority journal saphenous vein skin incision skin necrosis surgical technique vascular access vein bypass Adult Aged Aged, 80 and over Coronary Artery Bypass Diabetes Mellitus Endoscopy Feasibility Studies Female Human Male Middle Age Obesity Saphenous Vein Surgical Procedures, Minimally Invasive Vascular Diseases |
| description |
Background. Saphenous vein remains an elective conduit for up to 85% of coronary bypass operations. It is obtained through one or numerous skin incisions, with a reported morbidity varying from 5% to 25%. The endoscopic vein harvesting (EVH) technique was developed to minimize this morbidity and to improve clinical outcomes. The aim of this study was to review the feasibility of this method, its learning curve, and changing results in a group without previous experience in this procedure. Methods. Between July 1998 and October 1999, 179 patients for coronary artery bypass grafting underwent EVH (Vasoview Guidant, USA 'double access' and Uniport), by two operators. Results were reported based on time of harvesting, length of conduits, technical details, and clinical outcomes, and divided into six groups of 30 consecutive patients each. Results. Patient demographics were as follows: 86.03% were male, aged 64.3 ± 9.12 years (range, 43 to 92 years), with diabetes mellitus in 28.49%, obesity in 18.43%, and vascular disease in 11.17%. The EVH method was limited to the thigh in 77.65% of cases and extended to the leg in 22.35%. Patients received an average of 2.45 ± 0.58 incisions and obtained conduits had a mean length of 34.96 ± 9.65 cm (range, 15 to 70 cm). The number of venous bypasses per patient was 1.30 ± 0.59. Mean time of EVH was 47.24 ± 19.84 minutes (range, 15 to 120), with a length-time index of 0.85 ± 0.36. Primary success was achieved in 95.54%, with crossover to open technique in 4.46%. General morbidity was 8.9%, with hematoma in 1.11%, skin necrosis in 1.11%, infection in 6.7%, and readmission in 1.11%. Conclusions. Endoscopic vein harvesting is a feasible and reproductible method, with a typical learning curve, acceptable morbidity, and unquestionable benefits for coronary artery bypass graft patients.(C) 2000 by The Society of Thoracic Surgeons. |
| title |
Endoscopic saphenous vein harvesting: Initial experience and learning curve |
| title_short |
Endoscopic saphenous vein harvesting: Initial experience and learning curve |
| title_full |
Endoscopic saphenous vein harvesting: Initial experience and learning curve |
| title_fullStr |
Endoscopic saphenous vein harvesting: Initial experience and learning curve |
| title_full_unstemmed |
Endoscopic saphenous vein harvesting: Initial experience and learning curve |
| title_sort |
endoscopic saphenous vein harvesting: initial experience and learning curve |
| publishDate |
2000 |
| url |
https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00034975_v70_n3_p1086_Vrancic http://hdl.handle.net/20.500.12110/paper_00034975_v70_n3_p1086_Vrancic |
| _version_ |
1768541634968944640 |