机器人辅助心脏跳动下完全内镜下冠状动脉搭桥术对于体重指数（BMI）> 35的病态肥胖患者是否可行？
Is robotic beating heart totally endoscopic coronary artery bypass feasible for BMI > 35 morbidly obese patients?
作者信息
Kitahara Hiroto, Patel Brooke, McCrorey Mackenzie, Nisivaco Sarah, Balkhy Husam H
机构信息
Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA.
出版信息
Int J Med Robot. 2018 Aug;14(4):e1911. doi: 10.1002/rcs.1911. Epub 2018 Apr 23.
BACKGROUND
We investigated the outcomes of morbidly obese patients after robotic beating heart totally endoscopic coronary artery bypass (BH-TECAB).
METHODS
This is a retrospective single center study. From July 2013 to December 2016, the outcomes of patients undergoing BH-TECAB were reviewed.
RESULTS
A total of 234 patients underwent BH-TECAB (172 male, mean age 65.2 years). There were 43 morbidly obese patients defined as body mass index (BMI) greater than 35, and 191 non-morbidly obese patients. Postoperative complications, or mortality in morbidly obese and other patients were similar except for prolonged ventilation >24 h (11.6% vs 2.1%, P = 0.008).
CONCLUSIONS
Morbidly obese patients had an increased incidence of prolonged ventilation after BH-TECAB, but an otherwise reasonably low morbidity and mortality similar to patients with a lower BMI. We believe that adoption of robotics technology allows for BH-TECAB and can lead to improved outcomes in this high-risk population.
背景
我们研究了病态肥胖患者接受机器人辅助不停跳完全内镜下冠状动脉搭桥术（BH-TECAB）后的结果。
方法
这是一项回顾性单中心研究。回顾了2013年7月至2016年12月期间接受BH-TECAB的患者的结果。
结果
共有234例患者接受了BH-TECAB（172例男性，平均年龄65.2岁）。有43例病态肥胖患者，定义为体重指数（BMI）大于35，以及191例非病态肥胖患者。除通气时间延长>24小时外，病态肥胖患者和其他患者的术后并发症或死亡率相似（11.6%对2.1%，P = 0.008）。
结论
病态肥胖患者在BH-TECAB后通气时间延长的发生率增加，但其他方面发病率和死亡率与BMI较低的患者相似且合理地低。我们认为采用机器人技术可进行BH-TECAB，并可改善这一高危人群的结果。
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