Robotic versus sternotomy approach for closure of atrial septal defect
- VernacularTitle:机器人与经胸骨正中切开入路行房间隔缺损修补术的疗效对比
- Author:
Can LIU
1
;
Chengxin ZHANG
1
;
Zhuang LIU
1
;
Shenglin GE
1
Author Information
1. Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P.R.China
- Publication Type:Journal Article
- Keywords:
Minimally invasive surgical procedures;
robotic surgical procedures;
heart septal defects, atrial
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(05):529-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the short-term outcomes of surgical repair for atrial septal defect (ASD) with a robotic (da Vinci Si) approach versus a conventional open procedure. Methods Clinical data of 140 patients undergoing ASD closure in the First Affiliated Hospital of Anhui Medical University from January 2016 to May 2020 were retrospectively analyzed. The patients were divided into a robotic group and a sternotomy group according to different surgical methods. In the robotic group, there were 67 patients including 20 males and 47 females at a median age of 40.0 (25.0) years, and in the sternotomy group there were 73 patients including 23 males and 50 females at a median age of 41.0 (29.0) years. Multivariate linear regressions were used to produce risk-adjusted analysis of pertinent clinical characteristics. Kaplan-Meier analysis was performed to compare the speed of sternotomy versus robotic group returning to exercise or daily life. Results Robotic-assisted surgery was associated with significantly shorter 24 h postoperative drainage volume [220.0 (210.0) mL vs. 345.0 (265.0) mL, P<0.001], mechanical ventilation [6.0 (11.0) h vs. 8.0 (11.0) h, P=0.024], intensive care unit length of stay (LOS) [19.0 (19.0) h vs. 22.0 (25.0) h, P=0.005], postoperative hospital LOS [9.0 (5.0) d vs. 10.0(6.0) d, P=0.003], and a lower rate of perioperative blood transfusion (28.36% vs. 84.93%, P<0.001). After controlling for patient comorbidity in the multiple regression model, there remained a trend toward decreased 24 h postoperative drainage volume (β=–115.30, 95%CI–170.78 to –59.82, P<0.001), mechanical ventilation (β=–4.96, 95%CI –8.33 to –1.59, P=0.004) and postoperative hospital LOS (β=–2.31, 95%CI –3.98 to –0.63, P=0.007) in the robotic group. Kaplan-Meier analysis revealed that patients returned to exercise or daily life earlier in the robotic group [35.0 (32.0) d vs. 90.0 (75.0) d, P<0.001]. Conclusion Closure of ASD can be performed safely and effectively via robotic approach. And the minimally invasive technique is beneficial to postoperative recovery.
