Comparison Of Robotic-assisted Cardiac Surgery And Conventional Median Sternotomy In The Treatment Of Cardiac Myxoma
Ersin Kadirogullari, Burak Onan, Zinar Apaydın, Serdar Başgöze, Ünal Aydın.
Istanbul SBU Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey.
BACKGROUND: In recent years, robotic-assisted cardiac surgery has been started to be increasingly used in complex cardiac surgery. The aim of this study was to compare the results of robotic-assisted cardiac surgery and conventional median sternotomy in patients with cardiac myxoma. METHODS-The study included a total of 46 patients who underwent robotic-assisted cardiac surgery and conventional median sternotomy due to cardiac myxoma between January 2011 and September 2019. Sixteen of these patients underwent robotic-assisted cardiac surgery and 30 patients underwent conventional median sternotomy. Preoperative clinical data and intraoperative and postoperative results were compared. RESULTS-There was no significant difference between the two groups in terms of mean age (53.2±11.4 vs 54.7±13.2 years, p=0.715) and sex (Female: 5 patients [31.3%] vs. 17 patients [56.7%], p=0.100). Cross-clamp times(59.7±29.3 vs 29.4±12.2 minutes, p =0.001)and CPB times 107.8±52.7 vs. 58.3±26.8 minutes, p=0.001) were significantly higher in patients undergoing RACS.Postoperative pain levels were found to be significantly lower in patients undergoing robotic-assisted cardiac surgery (3.5±0.6 vs 4.2±0.9, p=0.022). Postoperative drainage was significantly lower in RACS patients. ( 150±48.3 vs 240±99.4 ml;p=0.001). Blood transfusion rate in the robotic-assisted cardiac surgery group was found to be significantly less than the group of patients undergoing conventional median sternotomy (5 patients [31.3%] vs 20 patients [66.7%], p=0.022). There was no significant difference between the two groups in terms of length of hospital stay (5.3±2.4 vs 6±2.4 days, p=0.385). There was no return to median sternetomy in robotic-assisted cardiac surgery patients. CONCLİSİONS- Robotic-assisted cardiac surgery can be performed effectively and safely in cardiac myxoma operations. In addition to less pain and less blood product usage, robotic surgery provides superior cosmetic results compared conventional median sternotomy.
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