الفهرس 
IHD & CABGOnly 14 pages are availabe for public view
 |  | from | 181 |  |  |
| | | from | 181 | | |
Abstract
Objective:
Evaluation of the efficiency, safety and complication of minimally invasive greater saphenous vein harvesting versus open method especially wound infection and vein graft failure.
Patients and methods:
We identified 650 articles through database searching, and 5 articles from other sources and references within articles. After removal of duplicates, 525 records were left. After screening of 285 records with related topics, 240 records were excluded with a reason included: irrelevant content, comments, editorial, review articles, and non-English language. After assessment of the remaining 63 articles for eligibility, we excluded 39 articles of non-randomized prospective and retrospective trials, one overlapped study, and 5 randomized prospective trials published before the year 2000. Finally, 19 randomized prospective studies published between 2000 and 2017, were included in synthesis. The sample size ranged from 32 to 255, with total number of 2408 patients. Minimally invasive vein (MVH) harvesting group included 1259 patients, endoscopic vein harvesting (EVH) subgroup included 907 patients, and conventional open vein harvesting (OVH) group included 1149 patients.
Results
EVH significantly reduced the odds of wound infection [OR (95% CI): 0.16(0.09-0.27)], P-value <0.001, with no heterogeneity between studies (I2 = 0%, P-value >0.10). EVH had non-significant effect on odds of graft occlusion [OR (95% CI): 1.24 (0.77-2.01)], P-value > 0.05, or graft stenosis [OR (95% CI): 0.85 (0.45-1.58)], P-value > 0.05, with no heterogeneity between studies for graft occlusion and graft stenosis (I2 = 0%, P-value >0.10). EVH significantly reduced the odds of pain incidence [OR (95% CI): 0.25 (0.12-0.51)], P-value <0.001, but non-significant moderate heterogeneity present between studies (I2 =0.50%, P-value <0.11).The proportion of conversion of EVH to OVH was evaluated in 9 studies including 582 patients. Conversion to OVH was reported in 47 patients (8%) and ranged from 3% to 15% [Proportion (95% CI): 0.072 (0.046 - 0.098), P-value = 0.01. Non-significant moderate heterogeneity in results between studies (I2 =0.34%, P-value >0.10).
Conclusion
Minimally invasive vein harvesting, especially EVH significantly reduces wound complications, reduces wound infection or cellulitis compared with OVH. EVH does not demonstrate an increase in angiographic graft failure or occlusion over OVH at 6 months or at greater than 1-year follow-up.