Krishnamoorthy Bhuvaneswari, Critchley William R, Venkateswaran Rajamiyer V, Barnard James, Caress Ann, Fildes James E, Yonan Nizar
Department of Cardiothoracic Surgery, University Hospital of South Manchester NHS Foundation Trust, Manchester, M23 9LT, UK.
The Transplant Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, M23 9LT, UK.
J Cardiothorac Surg. 2016 Apr 8;11:45. doi: 10.1186/s13019-016-0442-y.
Endoscopic vein harvesting is becoming one of the most favourable vein harvesting techniques in multiple bypass coronary surgery, due to its short term post-operative benefits with high patient satisfaction. However, long-term graft patency has been both supported and questioned in the literature. Graft failure can be affected by harvesting methods and operator's experience. Endoscopic vein harvesting is associated with a learning curve period, during which the incidence of vein trauma is high due to unfamiliarity with the surgical technique. There is a paucity of structured learning tools for novice practitioners, meaning that training differs significantly between hospital centres. Inconsistent training methods can lead to poor surgical technique, which can have a significant impact on vein quality and stress level of the practitioner. In turn, this can lead to increased postoperative complications and longer surgical duration. The main aim of this literature review is to understand the impact of the learning curve on the vein conduit and whether there is a requirement for a standardised training programme for the novice practitioners.
内镜下静脉采集正成为多支冠状动脉搭桥手术中最受欢迎的静脉采集技术之一，这得益于其术后短期获益以及较高的患者满意度。然而，文献中对于长期移植物通畅率既有支持的观点，也有质疑的声音。移植物失败可能会受到采集方法和术者经验的影响。内镜下静脉采集与一个学习曲线阶段相关，在此期间，由于对手术技术不熟悉，静脉损伤的发生率较高。对于新手从业者而言，缺乏结构化的学习工具，这意味着不同医院中心的培训差异很大。不一致的培训方法可能导致手术技术欠佳，进而对静脉质量和从业者的压力水平产生重大影响。反过来，这可能会导致术后并发症增加和手术时间延长。这篇文献综述的主要目的是了解学习曲线对静脉管道的影响，以及新手从业者是否需要标准化的培训方案。
