Sampath Hari Kumar, Lee Terence Ji Hui, Cher Chua E, Liang Shen, Cheong Ooi Oon, Kofidis Theo, Vitaly Sorokin, Sazzad Faizus
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore 119228, Singapore.
J Clin Med. 2024 Jun 11;13(12):3405. doi: 10.3390/jcm13123405.
The long saphenous vein is routinely used for coronary bypass graft (CABG) surgery, and two primary techniques are commonly utilized: endoscopic vessel harvesting (EVH) and open vessel harvesting (OVH). The aim of this study was to compare the clinical outcomes of the EVH and OVH techniques used for CABG within the confines of a tertiary hospital. The clinical data of all patients subjected to either EVH or OVH for CABG surgery between 2014 and 2018 were retrospectively analyzed. Statistical analysis was performed to discern variations in the rates of postoperative complications between EVH and OVH. A cohort of 1884 individuals were included in this study, 75.3% of whom underwent EVH. Notably, the incidence of postoperative leg wound complications was significantly different between the patients who underwent OVH and the patients who underwent EVH, with incidence rates of 18.6% and 32%, respectively ( < 0.001). Leg wound complications ( < 0.001; OR 1.946; 95% CI 1.528-2.477) and leg wound infections ( = 0.050, OR 1.517, 95% CI 0.999-2.303) were significantly associated with OVH. Moreover, leg wound hematoma ( = 0.039, OR = 0.402, 95% CI = 0.169-0.957) and EVH were strongly associated. The large sample of patients and the inclusion of a range of Asian ethnic groups provided notable insights into postoperative complications related to different modalities. EVH was associated with a lower incidence of postoperative leg wound complications, which suggests that EVH is a better modality for those undergoing CABG surgery.
大隐静脉常用于冠状动脉旁路移植术(CABG),通常采用两种主要技术:内镜下血管获取(EVH)和开放血管获取(OVH)。本研究的目的是在一家三级医院的范围内比较用于CABG的EVH和OVH技术的临床结果。对2014年至2018年间接受EVH或OVH进行CABG手术的所有患者的临床数据进行回顾性分析。进行统计分析以辨别EVH和OVH术后并发症发生率的差异。本研究纳入了1884名个体,其中75.3%接受了EVH。值得注意的是,接受OVH的患者和接受EVH的患者术后腿部伤口并发症的发生率存在显著差异,分别为18.6%和32%(<0.001)。腿部伤口并发症(<0.001;OR 1.946;95%CI 1.528 - 2.477)和腿部伤口感染(=0.050,OR 1.517,95%CI 0.999 - 2.303)与OVH显著相关。此外,腿部伤口血肿(=0.039,OR = 0.402,95%CI = 0.169 - 0.957)与EVH密切相关。大量的患者样本以及一系列亚洲种族群体的纳入为不同方式相关的术后并发症提供了显著的见解。EVH与术后腿部伤口并发症的较低发生率相关,这表明EVH对于接受CABG手术的患者来说是一种更好的方式。