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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

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Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 2000 March;7(1):35-43

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English, Italian

Harvesting the great saphenous vein using mini cutaneous incisions for coronary artery bypass

Russo D. A.

From the Specialisation School in Heart Surgery Hesperia Hospital, Modena, Italy Bologna University, Bologna, Italy


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Background. The aim of har­vest­ing the ­great saph­e­nous ­vein ­using ­mini cuta­ne­ous inci­sions is to ­obtain the ben­e­fits of oth­er ­forms of min­i­mal­ly inva­sive sur­gery, includ­ing endo­scop­ic pro­ce­dures, name­ly min­i­mis­ing the post­op­er­a­tive com­pli­ca­tions, reduc­ing the ­cost of pro­ce­dures and ensur­ing easi­er exe­cu­tion ­which reduc­es the ­time ­required for har­vest­ing with­out alter­ing the qual­ity of the ­venous ­graft ­obtained.
Methods. The tech­nique con­sists in mak­ing 2-cm inci­sions at 10-cm inter­vals. Using a retrac­tor, the ­vein is dis­sect­ed, dis­play­ing the col­lat­er­al branch­es ­that are ­then ­closed ­using met­al ­clips. The ­study ­aimed to com­pare the tech­nique ­using ­mini inci­sions (Group 1, 60 ­patients) ­with the stan­dard “open” tech­nique (Group 2, 60 ­patients). All ­patients ­were ran­dom­ly select­ed ­from two homo­ge­ne­ous pop­u­la­tions for the var­i­ables regard­ed as impor­tant ­risk fac­tors for post­op­er­a­tive com­pli­ca­tions.
Results. Reduced oper­a­tive bleed­ing was report­ed in Group 1, togeth­er ­with cor­rect cicat­risa­tion (100%), no inflam­ma­tion and no necro­sis or ­wound dehis­cence. Small hemat­o­mas (2%) ­were ­observed, but no cas­es of ­pain, lym­phat­ic alter­a­tions or infec­tion. The har­vest­ing ­time and ­costs ­were com­par­able to the stan­dard tech­nique.
Conclusions. The ­mini inci­sion tech­nique out­lined ­here ­offers great­er advan­tag­es com­pared to the tra­di­tion­al meth­od and endo­scop­ic meth­ods, and ­these advan­tag­es are fur­ther ­enhanced in ­patients ­with a ­high ­risk of post­op­er­a­tive com­pli­ca­tions.

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