Baishya Jitumoni, George Antony, Krishnamoorthy Jayaprakash, Muniraju Geetha, Chakravarthy Murali
Department of Anesthesiology and Critical care, Fortis Hospital, Bengaluru, Karnataka, India.
Ann Card Anaesth. 2017 Jan-Mar;20(1):57-60. doi: 10.4103/0971-9784.197837.
Minimally invasive (MI) cardiac surgery is a rapidly gaining popularity, globally as well as in India. We aimed to compare the outcome of MI to the conventional approach for coronary artery bypass graft (CABG) surgery.
This prospective, comparative study was conducted at a tertiary care cardiac surgical center. All patients who underwent CABG surgery via MI approach (MI group) from July 2015 to December 2015 were enrolled and were compared against same number of EuroSCORE II matched patients undergoing CABG through conventional mid-sternotomy approach (CON group). Demographic, intra- and post-operative variables were collected.
In MI group, duration of the surgery was significantly longer (P = 0.029). Intraoperative blood loss lesser (P = 0.002), shorter duration of ventilation (P = 0.002), shorter Intensive Care Unit stay (P = 0.004), shorter hospital stay (P = 0.003), lesser postoperative analgesic requirements (P = 0.027), and lower visual analog scale scores on day of surgery (P = 0.032) and 1 st postoperative day (P = 0.025). No significant difference in postoperative blood loss, blood transfusion, or duration of inotrope requirement observed. There was no conversion to mid-sternotomy in any patients, 8% of patients had desaturation intraoperatively. There was no operative mortality.
MI surgery is associated with lesser intraoperative blood loss, better analgesia, and faster recovery.
微创心脏手术在全球以及印度都迅速受到欢迎。我们旨在比较微创冠状动脉旁路移植术（CABG）与传统手术方法的疗效。
这项前瞻性比较研究在一家三级心脏外科中心进行。纳入了2015年7月至2015年12月期间通过微创方法接受CABG手术的所有患者（微创组），并与相同数量的通过传统正中胸骨切开术接受CABG的欧洲心脏手术风险评估系统（EuroSCORE）II匹配患者（对照组）进行比较。收集了人口统计学、术中和术后变量。
在微创组中，手术时间明显更长（P = 0.029）。术中失血量更少（P = 0.002），通气时间更短（P = 0.002），重症监护病房停留时间更短（P = 0.004），住院时间更短（P = 0.003），术后镇痛需求更少（P = 0.027），手术当天（P = 0.032）和术后第1天视觉模拟评分更低（P = 0.025）。术后失血量、输血或使用血管活性药物的时间无显著差异。所有患者均未转为正中胸骨切开术，8%的患者术中出现低氧血症。无手术死亡。
微创心脏手术术中失血量更少、镇痛效果更好且恢复更快。
