Abstract 12118: Saphenous Vein Harvesting Techniques for Coronary Artery Bypass Grafting: A Systematic Review and Network Meta-Analysis.
In: Circulation, Jg. 138 (2018-11-07), S. A12118
Online
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Introduction: The great saphenous vein (GSV) graft remains the most frequent used conduit for coronary artery bypass graft (CABG) surgery. A lot of debates about technique of GSV harvesting have occurred. Hypothesis: Evaluating the short-term and long-term outcomes of all different GSV harvesting techniques. Methods: A systematic review of 12 electronic databases was performed to identify all randomized controlled trials (RCTs) of any GSV harvesting techniques, including conventional, no-touch, minimally open, closed endoscopic vein harvesting (EVH), and open EVH techniques. The outcomes were short-term complications, pain, and other technique measurements, and long-term efficacy, including death, myocardial infarction (MI), and graft patency. All outcomes were analyzed using the frequentist network meta-analysis. The methodological quality of each RCT was assessed using the Cochrane Collaboration's tool. The study protocol has been registered in PROSPERO with registration number CRD42017073468. Results: Regarding the risk of infection/inflammation, compared to open EVH, minimally open, and closed EVH techniques, no-touch technique increased 17.7, 18.7, and 29 times; while conventional technique increased 2.6, 2.7, and 4.2 times, respectively. Conventional technique increased 8.5 and 3.2 times of the risk of post-operative lymph problems and sensibility disorders, compared to closed EVH technique. However, open EVH technique increased the risk of hematoma/ecchymosis of 1.5, 1.7, and 2.2 times, compared to minimally open, conventional, and closed EVH techniques. Regarding post-operative pain, no-touch and conventional techniques increased the mean score of visual analogue scale of 3.7 and 1.2, compared to open EVH technique. EVH and minimally open techniques reduced approximately 25-44 cm of length of skin incision, compared to conventional and open techniques. Those techniques were not significantly different regarding time of GSV harvesting, converting to conventional technique, length of harvested vein, vein injury, poor vein quality, length of hospitalization, and the long-term outcomes, including death, MI, and graft patency. Conclusions: For GSV harvesting for CABG surgery, the minimally invasive techniques, including minimally open and EVH, reduce the risks of in-situ complications and the length of skin incision, with the comparable quality of vein and long-term death, MI, and graft patency. [ABSTRACT FROM AUTHOR]
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Abstract 12118: Saphenous Vein Harvesting Techniques for Coronary Artery Bypass Grafting: A Systematic Review and Network Meta-Analysis.
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Autor/in / Beteiligte Person: | Mokhtar, Mohamed A ; Vuong, Nguyen Lam ; Elfaituri, Muhammed K ; Eid, Peter Samuel ; Eldoadoa, Mohammed Fathi ; Reda Mostafa, Mostafa ; Bendary, Ahmed Hesham ; Radwan, Ibrahim ; Aboelhossen, Mostafa Mohamed ; Ibrahim, Doaa Alaa ; Atef Abdallah, Nirmeen ; Abo El-Ghar, Heba ; Mostafa Mohamed Zaki, Marwa ; Elshafay, Abdelrahman ; Huy, Nguyen Tien |
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Zeitschrift: | Circulation, Jg. 138 (2018-11-07), S. A12118 |
Veröffentlichung: | 2018 |
Medientyp: | academicJournal |
ISSN: | 0009-7322 (print) |
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