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OBJECTIVE: This study is to compare long-term clinical outcomes of robotic myxoma resection with those in conventional approach.
METHODS: Between 2007 and 2013, 93 patients underwent robotic (ROBO group, n=49) or conventional sternotomy (STER group, n=44) atrial myxoma excision. In ROBO group, the mean tumor size was 43×52 mm (14×19 ~ 44×74mm). And Four tumors were in the right atrium and 45 tumors were in the left atrium, of which 39 tumors arose from the interatrial septum, 2 from the posterocaudal wall, 3 from the root of the anterior leaflet of the mitral valve, and 1 from the left atrial roof. Via 4 port incisions and a 1.5-cm working port, all th robotic procedures were completed with the da Vinci Surgical System. The exploration and excision were conducted through an oblique right atriotomy in STER group with conventional sternotomy. The clinical data were recorded and echocardiography was used as the diagnostic tool for follow-up. The Medical Outcomes Study Short Form Survey (SF-36) was administered to estimate the quality of life (QOL).
RESULTS: All cases were accomplished successfully. Average amounts of postoperative drainage, intubation time, ICU and postoperative length of stay in ROBO group were less than the STER group (p<0.05). There was no death during the hospitalization or in the follow-up period. One patient in 1 year postoperatively and 1 patient in 3 years postoperatively required reoperation for recurrence in STER group. For the ROBO group , the mean follow-up was 29±16 (1~60) months. No patient required reoperation for recurrence postoperatively. The quality of life scores in ROBO group were significantly higher than the STER group on postoperative day 30 (p<0.05). The patients in ROBO group appeared more satisfactory with their recovery and incision.
CONCLUSIONS: Compared with the conventional approach, robotic excision of atrial myxomas is efficacious, safe and with excellent long-term surgical result. And the patients underwent robotic surgery lived a high quality of life after surgery.