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Ann Thorac Surg 1999;68:2107-2110
© 1999 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Endoscopic versus open saphenous vein harvest: the effect on postoperative outcomes

Thomas Z. Hayward, III, MDa, Lloyd A. Hey, MDa, Lewis L. Newman, PA-Ca, Francis G. Duhaylongsod, MDa, Katharine A. Haywarda, James E. Lowe, MDa, Peter K. Smith, MDa

a Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA

Address reprint requests to Dr Hayward, Department of Surgery, Duke University Medical Center, PO Box 31091, Durham, NC 27710;
e-mail: haywa001{at}mc.duke.edu

Presented at the Forty-fifth Annual Meeting of the Southern Thoracic Surgical Association, Orlando, FL Nov 12–14, 1998.

Background. Endoscopic vein harvest (EVH) has been promoted as a possible solution to the wound complications, incisional pain, and prolonged convalesce associated with open vein harvesting (OVH). The purpose of this study was to objectively compare the two techniques.

Methods. One hundred patients were prospectively randomized to EVH or OVH. Primary outcomes were wound complications, pain (Medical Outcomes Study Pain Survey), and general health (SF-12). Secondary outcomes were operative times and patient preferences. Patients were assessed at hospital discharge, 3, and 6 weeks postdischarge.

Results. No significant differences were detected in the primary outcomes: leg infection (p = 0.75), incisional pain (p = 0.74), physical health (p = 0.84), mental health (p = 0.47), and postoperative length of stay (p = 0.74). However, patient preference for EVH was highly significant (p < 0.01).

Conclusions. EVH does not demonstrate significant differences compared with OVH. This, coupled with higher operating room costs, should limit its use until clinical benefit is shown. However, strong patient preference and demand for EVH overshadow equivocal clinical outcomes.




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