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Lymphatic Complication in Open Venous Harvesting Versus Endoscopic Venous Harvesting: A Systematic Review and Meta-Analysis Publisher Pubmed



Razavi A1, 2 ; Mahalleh M3 ; Vanaki A4 ; Fallah A4 ; Bahanesteh A4 ; Ahmadi A4 ; Yarmohammadi H5 ; Solati Kooshkqazi M6 ; Soltanipur M5, 7
Authors
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Authors Affiliations
  1. 1. Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
  2. 2. Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Medical Students Research Committee, Shahed University, Tehran, Iran
  5. 5. Quality of Life Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
  6. 6. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
  7. 7. General Practitioner (GP), Ebne-sina Medical Center (EMC), Tehran, Iran

Source: General Thoracic and Cardiovascular Surgery Published:2025


Abstract

Background: The methods for saphenous vein (SV) harvesting include bridging vein harvesting (BVH), open vein harvesting (OVH), and endoscopic vein harvesting (EVH). Lymphatic complications, such as lymphatic leak, lymphedema, lymphangitis, and lymphocele, can arise following SV-harvesting surgery. This study aims to compare the incidence of lymphatic complications in SV harvesting using the OVH surgical method versus EVH. Methods: We have systematically searched databases including Scopus, PubMed, and Web of Science until April 2024. Studies were considered eligible for inclusion if they performed SV harvesting and compared lymphatic complications in the EVH with OVH or BVH. Various lymphatic complications and follow-up periods were extracted. A meta-analysis was conducted comparing the relative risk (RR) of lymphatic complications in the EVH group versus the OVH group. Results: Twelve studies were included. A total of 1934 patients were involved and the majority were male. Follow-up times were from 6 days to 34 months. Results of the meta-analysis showed that the pooled lymphatic complications, lymphatic leak, and lymphedema are significantly higher in OVH versus EVH (RR = 6.78, p value < 0.01; RR = 17.33, p value < 0.01; RR = 8.88, p value < 0.01, respectively). No significant differences in lymphocele rates between the two methods (RR = 1.2, p value = 0.77). Both short-term and long-term follow-ups showed elevated lymphatic complication risks in OVH relative to EVH (RR = 4.91, p value < 0.01; RR = 30.27, p value = 0.03, respectively). Conclusion: EVH is linked to reduced rates of lymphatic complications. Also, OVH had a higher risk of lymphatic complications in the short and long term compared to EVH. © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2025.
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