Cem ARITÜRK, Murat ÖKTEN, Ümit GÜLLÜ, Şahin ŞENAY, Leyla KILIÇ, Mehtap ADIGÜZEL, Fevzi TORAMAN, Hasan KARABULUT, Cem ALHAN

Endoskopik Safen Ven Hazırlanması: Türkiye’deki İlk Deneyimler

Amaç: Endoskopik safen ven grefti hazırlanması EVH son yıllarda, bazı kliniklerde rutin olarak kullanılmakta olan ve postoperatif dönemde morbiditeyi azaltıp hasta memnuniyetini arttıran bir cerrahi tekniktir. Hastalar ve Yöntemler: Acıbadem Maslak ve Acıbadem Kadıköy Hastaneleri’nde Ekim 2012 ile Mart 2013 tarihleri arasında safen ven greftleri SVG ; kapalı, karbondioksit insuflasyonu kullanılarak endoskopik yöntem ile The VasoViewTM System, Maquet hazırlanan 55 vaka incelendi. Hastaların endoskopik teknikle hazırlanan SVG’lerinin uzunlukları, toplam SVG hazırlanma süresi, postoperatif ağrı skorları, hematom-yara yeri enfeksiyonu gibi lokal bulguları ve gelişen diğer komplikasyonlar kaydedildi. Bulgular: Tüm hastalarda SVG, EVH yöntemi ile hazırlandı, açık tekniğe geçiş olmadı. 2 hastada hazırlanan SVG’lerde gözlenen lokal disseksiyon alanları nedeni ile kısmi olarak kullanılamayan segmentler saptandı. Sonuç: Özellikle EVH tekniğini öğrenme sürecinin tamamlanmasının ardından EVHnin hem hastanın kozmetik memnuniyeti açısından hem de postoperatif morbiditeyi azaltması açısından başarılı olacağını düşünmekteyiz.

Endoscopic Safen Vein Harvesting : First Experiences In Turkey

Objectives: Endoscopic safenous vein harvesting EVH has been a routine technique in some cardiovascular surgery clinics, especially in U.S.A, and decreases the postoperative morbidity, resulting in increased patient satisfaction. Patients and Methods: 55 patients that had undergone EVH procedure with closed, carbondioxide insufflated endoscopic system The VasoViewTM System, Maquet during first time isolated coronary artery bypass grafting surgery, in Acıbadem Maslak and Kadikoy Hospitals between October 2012 and March 2013 were evaluated. Safenous vein grafts’ SVG length, total harvesting times, postoperative pain scores, complications as well as hematoma and surgery site enfections were recorded. Results: All SVGs were harvested endoscopically, there was no need for conversion to open technique. In 2 patients’ SVGs, local dissected segments were noticed but the rest of the SVGs could be used. Conclusion: We suggest that EVH, especially after the learning curve is completed, is a better method than open technique in SVG harvesting as it decreases the postoperative mortality while increasing the patient satisfaction.

Keywords:

Endoscopy, safen vein graft harvesting, coronary bypass,

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