Learning Curve for Using Endoscopic Saphenous Vein Harvesting in Coronary Artery Bypass Grafting
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240305.009
- VernacularTitle:经内窥镜大隐静脉获取术在冠状动脉旁路移植术中应用的学习曲线
- Author:
Weihua ZHANG
1
;
Jian ZHANG
1
;
Xiaoke SUN
1
;
Hong LUO
1
;
Ning MA
1
;
Donghai LIU
1
;
Xin ZHANG
1
;
Chenhui QIAO
1
Author Information
1. Department of Cardiovascular Surgery， the First Affiliated Hospital of Zhengzhou University， Zhengzhou 450000， China
- Publication Type:Journal Article
- Keywords:
coronary artery bypass grafting;
endoscopy;
minimally invasive;
great saphenous vein;
learning curve
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2024;45(2):319-323
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the application of endoscopy in obtaining the great saphenous vein （GSV） during coronary artery bypass grafting （CABG） and explore the learning curve， with a particular focus on common challenges encountered during the learning process and their impact on early clinical outcomes. MethodsA retrospective analysis was conducted on clinical data from 83 patients who underwent off-pump CABG with endoscopic GSV harvesting at the First Affiliated Hospital of Zhengzhou University from July 2013 to April 2014. Patients were categorized into four groups based on the chronological order of their hospitalization： Group A （novice group， n=20）， Group B （proficient group， n=20）， Group C （progressive group， n=20）， and Group D （mature group， n=23）. Differences in perioperative and midterm follow-up outcomes among the groups were analyzed to determine the learning curve period. ResultsThe study population had a mean age of （60.22±8.06） years and a mean body weight of （69.77±11.66） kg. Comorbidities included hypertension （24 cases）， diabetes （26 cases）， and subacute cerebral infarction （14 cases）. The novice group exhibited significantly shorter GSV length-to-harvest time ratio relative to the other three groups （P<0.001） and a significantly higher incidence of main vein damage （P=0.006）. However， there was no statistically significant difference in graft patency at the 1-year follow-up. ConclusionThorough and reliable technical training in endoscopic GSV harvesting is essential to minimize vascular injury caused by novice operators. Approximately 20 cases of hands-on experience and a careful self-analysis of procedural challenges are likely required to achieve proficiency in GSV harvesting.
