Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey.
Department of Cardiovascular Surgery, Tatvan State Hospital, Tatvan, Turkey.
J Card Surg. 2021 Sep;36(9):3126-3130. doi: 10.1111/jocs.15758. Epub 2021 Jun 20.
Robotic cardiac surgery offers mitigated risks for obese patients requiring mitral valve surgery. We aimed to study the safety of robotic mitral surgery in the obese patient population by analyzing the outcomes of mitral surgery patients in our center for robotic cardiac surgery.
This study retrospectively included 123 consecutive patients who underwent robotic mitral valve operations in a single center for robotic cardiac surgery. Patients with body mass index (BMI) ≥ 30 were compared against patients with BMI < 30 for demographic and operative parameters as well as postoperative outcomes.
Mean BMI was 33.9 ± 2.8 in the obesity group (n = 87) and 25.4 ± 2.7 in the no-obesity group (n = 36). Female gender (80.6% vs. 52.9%, p = .004), diabetes (25.0% vs. 10.3%, p = .036), and hypertension (48.6% vs. 26.4%, p = .018) were more common in patients with obesity. The obesity group was operated with similar cardiopulmonary bypass and total operative times with the no-obesity group. Postoperative drainage and blood transfusion requirements were similar between the groups. Mechanical ventilation times (6.1 ± 2.2 vs. 8.0 ± 4.4 h, p = .003) and intensive care unit stay (20.4 ± 1.6 vs. 29.4 ± 3.7, p = .027) were shorter in the obesity group. Other postoperative outcomes of infection, atrial fibrillation, hospital stay duration, and readmission rates were similar between the groups.
Robotic mitral surgery is safe to perform in obese patients. Obesity should not be a contraindication for robotic mitral surgery as obese patients have outcomes similar to nonobese patients despite increased challenges and risk-factors.
机器人心脏手术为需要二尖瓣手术的肥胖患者提供了降低风险。我们旨在通过分析我们中心接受机器人心脏手术的二尖瓣手术患者的结果，研究肥胖患者接受机器人二尖瓣手术的安全性。
本研究回顾性纳入了在单一机器人心脏手术中心接受机器人二尖瓣手术的 123 例连续患者。比较 BMI≥30 的患者与 BMI<30 的患者在人口统计学和手术参数以及术后结果方面的差异。
肥胖组（n=87）的平均 BMI 为 33.9±2.8，非肥胖组（n=36）的平均 BMI 为 25.4±2.7。肥胖组女性比例（80.6% vs. 52.9%，p=0.004）、糖尿病（25.0% vs. 10.3%，p=0.036）和高血压（48.6% vs. 26.4%，p=0.018）更为常见。肥胖组的体外循环和总手术时间与非肥胖组相似。两组术后引流和输血需求相似。两组机械通气时间（6.1±2.2 vs. 8.0±4.4 h，p=0.003）和重症监护病房停留时间（20.4±1.6 vs. 29.4±3.7，p=0.027）均较短。两组间感染、心房颤动、住院时间和再入院率等其他术后结果相似。
机器人二尖瓣手术在肥胖患者中是安全的。肥胖不应成为机器人二尖瓣手术的禁忌症，因为肥胖患者的结局与非肥胖患者相似，尽管存在更多的挑战和风险因素。
