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Endoscopic versus open harvesting of radial artery for CABG
The Cardiothoracic Surgeon  (IF),  Pub Date : 2020-01-06, DOI: 10.1186/s43057-019-0012-x
Mohamed Abdel Hafez Fouly

Endoscopic harvest of the radial artery avoids long forearm incisions and has better cosmesis compared to the open technique. The objective of this study was to compare the short-term results and wound-related complications of endoscopic radial artery harvest versus open technique. From 2013 to 2017, 800 patients had coronary artery bypass grafting; 88 patients of them had radial artery harvesting (11%). Two groups were included in the study according to the surgeon preference, endoscopic radial harvest (group 1, n = 30; 3.75% of total CABG patients) and open harvest (group 2, n = 58; 7.25% of total CABG patients). Group 1 had more males (25 (83.33%) vs. 35 (60.34%); p = 0.028). There was no difference in the preoperative comorbidities between both groups. The duration of the harvest was significantly longer in group 1 (median 40 min ranges from 38 to 42 min vs. 49 min ranges from 47 to 52 min in groups 1 and 2, respectively; p < 0.001). The operative time was longer in group 1 (median 302.5 min ranges from 295 to 310 min vs. 277 min ranges from 273 to 280 min in groups 1 and 2, respectively; p < 0.001). The hospital stay in the endoscopic radial artery harvest group was significantly shorter than that of open technique (median 7 days ranges from 6 to 7 days vs. 7.5 days ranges from 7 to 9 days; p < 0.001). There was no significant difference in the postoperative complications between both groups. One case (3.3%) was transformed from the endoscopic to open technique due to uncontrolled bleeding. Endoscopic technique was associated with more patients presenting with hand numbness (6 cases; 20% versus 3 cases 5.2%) and radial nerve injury (2 cases; 6.6% versus none), while open technique showed more cases of local hematoma (8 cases; 13.8% versus 1 case; 3.3%) and wound infection (6 cases; 10.34% versus none); p > 0.05. Endoscopic radial artery harvest is associated with shorter harvest time and shorter hospital stay. Endoscopic radial artery harvest is a safe technique with good short-term outcomes. Longer follow-up is recommended.