Lymphedema after saphenous harvesting for coronary artery bypass surgery: case report and literature review

Lymphatic complication in open venous harvesting versus endoscopic venous harvesting: a systematic review and meta-analysis

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.

Effect of Chamomile and Olive Oils on Volume, Range of Motion, and Quality of Life in Breast Cancer-Related Lymphedema: A Randomized Controlled Trial

Background: Lymphedema is one of the disturbing complications after breast cancer treatment that may affect the quality of life (QoL) of breast cancer survivors (BCSs). Methods: In this double-blind randomized clinical trial, 63 patients with breast cancer-related lymphedema (BCRL) were included in the study. Group A received standard complete decongestive therapy (CDT), group B received CDT with olive oil, and group C received CDT with chamomile and olive oil. Lymphedema volume and range of motion (RoM) were measured at the beginning of the study and at sessions 7, 14, and 21. Patients' QoL was measured using the Short Form 36 questionnaire at baseline, at the end of the trial, and 1 month after the trial. For statistical analysis, SPSS software with a significance level of p < 0.05 was used. Results: The mean age of patients was 55.4 ± 10.1 years. Although the volume of lymphedema was reduced and RoM was increased in all groups, there was no significant difference between the three groups. However, the change in volume and RoM was more evident in group C. Moreover, the effect of interventions on health-related QoL dimensions in all groups was not statistically significant. However, in some dimensions, the score did not decrease in group B during follow-up. Conclusions: Chamomile and olive oils are tolerable for BCSs with BCRL; however, adding this intervention to CDT seems to have no superiority to CDT alone.