Endoscopic versus open saphenous vein harvest: The effect on postoperativeoutcomes

Background.. Endoscopic vein harvest (EVH) has been promoted as a possible solution to the wound complications, incisional pain, and prolonged convale sce associated with open vein harvesting (OVH). The purpose of this study w as 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 Pai n Survey), and general health (SF-12). Secondary outcomes were operative ti mes 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 dem and for EVH overshadow equivocal clinical outcomes. (C) 1999 by The Society of Thoracic Surgeons.