Purpose: To evaluate clinical outcomes following endoscopic and traditional saphenous vein harvesting.

Methods: One hundred twelve (112) patients undergoing elective coronary artery bypass grafting were prospectively randomized to either an endoscopic technique (Group A, n=54) or a traditional longitudinal incision (Group B, n=58) for saphenous vein harvesting. Groups A and B, respectively, were similar with regard to length of vein harvested (41±8 vs 40±14 cm), bypasses done (4.1±1.1 vs 4.2±1.4), age, preoperative risk stratification, and risk for wound complications (diabetes, gender, obesity, preoperative anemia, hypoalbuminemia, arterial insufficiency, and steroid use). Leg wound complications were defined as: hematoma, dehiscence, cellulitis, necrosis, or abscess requiring dressing changes, antibiotics, or debridement prior to complete epithelialization. Three patients (5.6%) in Group A were converted to traditional harvest and excluded from analysis.

Results: Leg wound complications in Group A and Group B were 4% (2/51) and 19% (11/58), respectively. Chi-square univariate analysis identified traditional longitudinal incision (p<.02) and diabetes (p<.05) as risk factors for leg wound complications. Multivariate analysis identified only the traditional harvest technique (p<.03) as a predictor of leg wound complications. Mortality, reoperation for bleeding, and myocardial infarction rates were similar in both groups. Harvest rate (0.9±0.4 vs 1.2±0.5 cm/min) was slower for Group A (p<.02). Postoperative length of stay was reduced in Group A (mean 5.5±1.7 vs 6.5±2.6 days, p<.05). Operating room costs were increased for Group A (p<.01), however, overall hospital costs were similar in both groups.

Conclusions: Endoscopic saphenous vein harvesting is associated with fewer wound complications than the traditional longitudinal method.