Endoscopic vein harvesting improves postoperative outcome of CABG patients

Objective: Wound complications at the legs are frequent especially in diabetic patients after coronary bypass surgery. We analyzed the influence of the endoscopic venous harvesting technique on the incidence of wound complications compared to the traditional approach.

Methods: The study evaluated 255 patients with isolated CABG procedures. In 153 patients (EVH-group) the saphenous vein was harvested by endoscopic approach with the Guidant VasoView VI device. The remaining patients underwent vein harvesting using the traditional open approach (TVH-group). Fifty nine patients of the EVH-group (39%) and 31 of the TVH-group (44%) had diabetes. Observed parameters were postoperative pain and complications in wound healing as hematoma, dehiscence, cellulitis, necrosis or absess.

Results: In the EVH-group pain was reported at 3% in non-diabetic as well as in diabetic patients compared to 10% in non-diabetic and 19% of diabetic patients of the TVH-group (p<0.05). Complications of wound healing were observed at 4% in non-diabetic and at 7% in diabetic patients (n.s., EVH-group). In the TVH-group complications were present at 9% in non-diabetic and at 26% in diabetic patients (p<0.05). Pain as well as incidence of wound complications was significant lower in the EVH-group (p<0.05) for both the diabetic and the non-diabetic patients, respectively.

Conclusions: Endoscopic vein harvesting for CABG lowers the risk for wound complication as well as for postoperative pain. Especially diabetic patients benefit from the endoscopic approach.