机器人辅助微创非体外循环冠状动脉搭桥手术治疗永久性气管造口患者
Robotically Assisted Minimally Invasive Off-Pump Coronary Artery Bypass Surgery in a Patient With Permanent Tracheostomy.
作者信息
Ramponi Fabio, Flynn Campbell D, Wilson Michael K
机构信息
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia; The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, NSW, Australia.
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia; The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, NSW, Australia.
出版信息
Heart Lung Circ. 2017 Nov;26(11):e65-e67. doi: 10.1016/j.hlc.2017.02.025. Epub 2017 Apr 7.
BACKGROUND
Patients with a permanent tracheostomy requiring coronary surgery represent a unique challenge, being at increased risk of sternal wound complications, mediastinitis and stoma necrosis. Several techniques have been described including manubrium sparing sternotomy, thoracoscopic internal mammary harvest and hybrid revascularisation.
METHODS
We report a case of robotic assisted (daVinciXi™ Surgical System) total arterial off-pump revascularisation in a patient with previous laryngectomy and permanent tracheostomy. The main advantage of this approach was to minimise the risk of postoperative sternal complication and mediastinatis, whilst still providing the prognostic benefit of total arterial grafting and the neurological advantage of the aorta no-touch technique.
背景
需要进行冠状动脉手术的永久性气管造口术患者面临着独特的挑战，发生胸骨伤口并发症、纵隔炎和造口坏死的风险增加。已经描述了几种技术，包括保留胸骨柄的胸骨切开术、胸腔镜下胸廓内动脉获取术和杂交血运重建术。
方法
我们报告了一例先前接受喉切除术和永久性气管造口术的患者，采用机器人辅助（daVinciXi™手术系统）非体外循环全动脉血运重建术。这种方法的主要优点是将术后胸骨并发症和纵隔炎的风险降至最低，同时仍能提供全动脉搭桥的预后益处和主动脉免接触技术的神经学优势。
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