机器人辅助冠状动脉搭桥手术：18年单中心经验
Robotic-assisted coronary artery bypass surgery: an 18-year single-centre experience.
作者信息
Giambruno Vincenzo, Chu Michael W, Fox Stephanie, Swinamer Stuart A, Rayman Reiza, Markova Zarina, Barnfield Rebecca, Cooper Mitchell, Boyd Douglas W, Menkis Alan, Kiaii Bob
机构信息
Division of cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, London, Ontario, Canada.
Division of Cardiac Surgery, University of California Davis, Sacramento, California, USA.
出版信息
Int J Med Robot. 2018 Jun;14(3):e1891. doi: 10.1002/rcs.1891. Epub 2018 Jan 19.
BACKGROUND
Minimally invasive robot-assisted direct coronary artery bypass (RADCAB) has emerged as a feasible minimally invasive surgical technique for revascularization that might offer several potential advantages over conventional approaches. We present our 18-year experience in RADCAB.
METHODS
Between February 1998 and February 2016, 605 patients underwent RADCAB. Patients underwent post-procedural selective graft patency assessment using cardiac catheterization.
RESULTS
The mortality rate was 0.3%. The rate of conversion to sternotomy for any cause was reduced from 16.0% of the first 200 cases to 6.9% of the last 405 patients. The patency rate of the LITA-to-LAD anastomosis was 97.4%. Surgical re-exploration for bleeding occurred in 1.8% of patients, and the transfusion rate was 9.2%. Average ICU stay was 1.2 ± 1.4 days, and average hospital stay was 4.8 ± 2.9 days.
CONCLUSIONS
Robot-assisted coronary artery bypass grafting is safe, feasible and it seems to represent an effective alternative to traditional coronary artery bypass grafting in selected patients.
背景
微创机器人辅助直接冠状动脉旁路移植术（RADCAB）已成为一种可行的微创血管重建手术技术，与传统方法相比可能具有若干潜在优势。我们介绍我们18年来开展RADCAB的经验。
方法
1998年2月至2016年2月期间，605例患者接受了RADCAB。患者术后采用心导管检查进行选择性移植物通畅性评估。
结果
死亡率为0.3%。因任何原因转为胸骨切开术的比例从前200例中的16.0%降至最后405例患者中的6.9%。左内乳动脉至左前降支吻合口的通畅率为97.4%。1.8%的患者因出血进行了手术再次探查，输血率为9.2%。平均重症监护病房停留时间为1.2±1.4天，平均住院时间为4.8±2.9天。
结论
机器人辅助冠状动脉旁路移植术是安全可行的，对于特定患者似乎是传统冠状动脉旁路移植术的有效替代方法。
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