机器人辅助冠状动脉搭桥术：196例手术的可行性及临床结果
Robotically enhanced coronary artery bypass grafting: the feasibility and clinical outcome of 196 procedures.
作者信息
Caynak Baris, Sagbas Ertan, Onan Burak, Onan Ismihan Selen, Sanisoglu Ilhan, Akpinar Belhhan
机构信息
Department of Cardiovascular Surgery, Istanbul Bilim University, Florence Nightingale Hospital, Istanbul, Turkey.
出版信息
Int J Med Robot. 2009 Jun;5(2):170-7. doi: 10.1002/rcs.244.
BACKGROUND
The aim of this study was to assess the feasibility of robotically enhanced myocardial revascularization and to present the clinical outcome of 196 patients.
METHODS
All internal thoracic arteries were harvested with the aid of a robotic surgical system. While off-pump revascularization techniques were mostly used, peripheral cardiopulmonary bypass was needed in some cases with multivessel disease.
RESULTS
A single (n = 118) or multivessel (n = 74) coronary revascularization was performed. Four patients had to be converted to median sternotomy. There was no operative mortality. Follow-up was complete in 88% (n = 169) patients. The rate of freedom from ischaemic symptoms was 98.2% at mean 22 +/- 3 months. Graft patency was 96.4% (81/84).
CONCLUSIONS
By increasing surgical capabilities, robotically enhanced CABG in single or multivessel coronary disease was safe, effective and reasonable. It can be an alternative approach to percutaneous methods and conventional surgical techniques, or even used in acute coronary events.
背景
本研究的目的是评估机器人辅助心肌血运重建的可行性，并展示196例患者的临床结果。
方法
所有胸廓内动脉均借助机器人手术系统获取。虽然大多采用非体外循环血运重建技术，但在一些多支血管病变的病例中需要使用外周体外循环。
结果
进行了单支血管（n = 118）或多支血管（n = 74）冠状动脉血运重建。4例患者不得不转为正中开胸手术。无手术死亡。88%（n = 169）的患者完成了随访。在平均22±3个月时，无缺血症状的发生率为98.2%。移植血管通畅率为96.4%（81/84）。
结论
通过提高手术能力，机器人辅助的单支或多支血管冠状动脉搭桥术安全、有效且合理。它可以作为经皮方法和传统手术技术的替代方法，甚至可用于急性冠状动脉事件。
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