Great saphenous vein harvesting: a systematic review and meta-analysis of open versus endoscopic techniques. 2009

Rosemary Anne Cadwallader, and Stewart R Walsh, and David G Cooper, and Tjun Y Tang, and Umar Sadat, and Jonathan R Boyle
Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, UK. Rosie1878@doctors.org.uk

BACKGROUND The great saphenous vein is frequently harvested for use as a conduit in lower limb bypass surgery. A number of papers advocate the use of an endoscopic technique rather than a traditional open technique to minimize the associated morbidity. We undertook a systematic review and meta-analysis to compare morbidity associated with these 2 techniques. METHODS Medline, PubMed, and secondary referencing identified 16 randomized control trials comparing these 2 methods of harvesting. Primary outcome measures were infection, hematoma, and wound dehiscence and pooled odds ratios (POR) were calculated using a random effects model. RESULTS Sixteen trials (3689 patients) were identified. Overall complications (POR 7.03), infection (POR 8.08), and wound dehiscence (POR 8.23) were all significantly more common in the open harvesting group compared to the endoscopic group. CONCLUSIONS Endoscopic techniques have a role in vein harvesting but are operator dependent and therefore are only a preferable modality compared to open harvesting methods in experienced hands. More research is required to establish whether long-term patency rates are comparable for the 2 techniques.

UI MeSH Term Description Entries
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D006406 Hematoma A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue. Hematomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012501 Saphenous Vein The vein which drains the foot and leg. Saphenous Veins,Vein, Saphenous,Veins, Saphenous
D013529 Surgical Wound Dehiscence Pathologic process consisting of a partial or complete disruption of the layers of a surgical wound. Dehiscence, Surgical Wound,Wound Dehiscence, Surgical
D013530 Surgical Wound Infection Infection occurring at the site of a surgical incision. Postoperative Wound Infection,Infection, Postoperative Wound,Infection, Surgical Wound,Surgical Site Infection,Wound Infection, Postoperative,Wound Infection, Surgical,Infection, Surgical Site,Infections, Postoperative Wound,Infections, Surgical Site,Infections, Surgical Wound,Postoperative Wound Infections,Surgical Site Infections,Surgical Wound Infections,Wound Infections, Postoperative,Wound Infections, Surgical
D016017 Odds Ratio The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. Cross-Product Ratio,Risk Ratio,Relative Odds,Cross Product Ratio,Cross-Product Ratios,Odds Ratios,Odds, Relative,Ratio, Cross-Product,Ratio, Risk,Ratios, Cross-Product,Ratios, Risk,Risk Ratios
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D018570 Risk Assessment The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988) Assessment, Risk,Benefit-Risk Assessment,Risk Analysis,Risk-Benefit Assessment,Health Risk Assessment,Risks and Benefits,Analysis, Risk,Assessment, Benefit-Risk,Assessment, Health Risk,Assessment, Risk-Benefit,Benefit Risk Assessment,Benefit-Risk Assessments,Benefits and Risks,Health Risk Assessments,Risk Analyses,Risk Assessment, Health,Risk Assessments,Risk Benefit Assessment,Risk-Benefit Assessments
D020858 Tissue and Organ Harvesting The procedure of removing TISSUES, organs, or specimens from DONORS for reuse, such as TRANSPLANTATION. Organ Harvesting,Organ Retrieval,Tissue Harvesting,Organ Harvestings,Organ Retrievals,Retrieval, Organ,Retrievals, Organ

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