Comparison of endoscopic and open saphenous vein harvesting: Impact on postoperative in-hospital outcomes

Abstract

Objectives: This study aimed to investigate the cost-effectiveness, technical feasibility, and potential benefits associated with endoscopic saphenous vein harvesting. Patients and methods: This study included a total of 122 patients who underwent coronary bypass surgery with saphenous vein grafts between January 2022 and March 2023. Fifty-six (44 males, 12 females; mean age: 62.5±8.6 years; range, 43 to 77 years) of the patients were assigned to the endoscopic harvesting group, while 66 patients (57 males, 9 females; mean age: 60.1±9.1 years; range, 42 to 81 years) were assigned to the open harvesting group. This study compares endoscopic saphenous harvesting and open technique in terms of clinical implications, including wound healing and clinical recovery and patients' pain experiences. Results: Among the comorbidities evaluated, the prevalence of hypertension, type 2 diabetes mellitus, and chronic kidney disease did not show statistically significant differences between the two groups. There were no reported cases of graft branch complications, graft-related bleeding, or graft thrombosis in either group. However, the occurrence of wound discharge was significantly lower in the endoscopic group (0%) compared to the open group (13.6%). Patients who underwent endoscopic saphenous vein harvesting also experienced less pain and had a significantly lower incidence of keloid scar formation at the wound site. Both groups had comparable rates of debridement, while systemic infection was observed in 0% of the endoscopic group and 1.5% of the open group. Wound site infection was lower in the endoscopic group (0%) compared to the open group (4.5%). The length of hospital stay in the ward did not show a significant difference between the two groups. However, the time required for wound dressing was significantly shorter in the endoscopic group compared to the open group. Conclusion: These findings suggest potential advantages of endoscopic surgery in terms of reduced postoperative complications and faster wound healing.