Efficacy of robot-assisted surgery system versus total thoracoscopy for atrial septal defect repair on a beating heart_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Ning ,  ZHANG Chengxin , GE Shenglin , XU Jinguo , LIU Zhuang , LI Yanli

Department of Cardiac Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P.R.China;

Corresponding author：

ZHANG Chengxin, Email: lancetcharles@163.com

Keywords：

Robot; aortic valve replacement; minimally invasive cardiac surgery; atrial septal defect repair

DOI：

10.7507/1007-4848.201910040

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To observe the short-term therapeutic outcomes of atrial septal defects (ASD) repair using on-pump beating-heart technique assisted by robotic surgery system (Da Vinci Si) or thoracoscopy.Methods Clinical data of 50 patients undergoing ASD repair at the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2018 were retrospectively analyzed. According to the different surgical methods, patients were divided into a robot group and a total thoracoscopy group. In the robot group, there were 35 patients including 11 males and 24 females, at an average age of 42.1±16.8 years, and in the total thoracoscopy group there were 15 patients including 8 males and 7 females at an average age of 38.4±10.9 years. During follow-up, the left ventricular ejection fraction, left and right atrial diameter, and right ventricular end-diastolic diameter in the cardiac Doppler echocardiography were recorded. The operation time, extracorporeal circulation time, ventilation time, postoperative ICU stay, postoperative hospital stay, perioperative pleural drainage and early complications were compared between the two groups.Results In the perioperative period, the robot group had less operation time (3.8±0.3 h vs. 6.1±1.4 h), extracorporeal circulation time (72.3 ± 10.4 min vs. 139.1 ± 32.8 min), ventilation time (5.5±1.2 h vs. 9.5 ± 2.1 h), postoperative hospital stay (6.7±0.5 d vs. 9.8 ± 0.6 d) and thoracic drainage (253.4±26.8 mL vs. 289.3 ± 29.5 mL) than the total thoracoscopy group (P<0.05), while the postoperative complications were not statistically significant between the two groups (P>0.05). All patients were reviewed by color Doppler ultrasound at 1 month after operation. The postoperative dilated right atrium, right ventricle and left atrium were smaller than those before surgery.Conclusion For patients undergoing ASD repair, robot-assisted and total thoracoscopy can achieve good results, but the robot group has more advantages in terms of operation time, extracorporeal circulation time, ventilation time, postoperative hospital stay and thoracic drainage.

Citation： LI Ning, ZHANG Chengxin, GE Shenglin, XU Jinguo, LIU Zhuang, LI Yanli. Efficacy of robot-assisted surgery system versus total thoracoscopy for atrial septal defect repair on a beating heart. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(2): 168-172. doi: 10.7507/1007-4848.201910040 Copy

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10.	陈峙公, 尤涛, 王子政, 等. 心外科胸腔镜与机器人辅助手术结局指标的比较. 腹腔镜外科杂志, 2018, 23(12): 923-926.
11.	Yu HY, Friedlander DF, Patel S, et al. The current status of robotic oncologic surgery. CA Cancer J Clin, 2013, 63(1): 45-56.
12.	Hu LD, Li XF, Wang XY, et al. Robotic versus laparoscopic gastrectomy for gastric carcinoma: a meta-analysis of efficacy and safety. Asian Pac J Cancer Prev, 2016, 17(9): 4327-4333.
13.	Cui Y, Li C, Xu Z, et al. Robot-assisted versus conventional laparoscopic operation in anus-preserving rectal cancer: a meta-analysis. Ther Clin Risk Manag, 2017, 13: 1247-1257.
14.	Li X, Wang T, Yao L, et al. The safety and effectiveness of robot-assisted versus laparoscopic TME in patients with rectal cancer: A meta-analysis and systematic review. Medicine (Baltimore), 2017, 96(29): e7585.
15.	Gong W, Cai J, Wang Z, et al. Robot-assisted coronary artery bypass grafting improves short-term outcomes compared with minimally invasive direct coronary artery bypass grafting. J Thorac Dis, 2016, 8(3): 459-468.

1. Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol, 2008, 52(23): e143-e263.
2. Baumgartner H, Bonhoeffer P, De Groot NM, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J, 2010, 31(23): 2915-2957.
3. Lee BE, Korst RJ, Kletsman E, et al. Transitioning from video-assisted thoracic surgical lobectomy to robotics for lung cancer: are there outcomes advantages? J Thorac Cardiovasc Surg, 2014, 147(2): 724-729.
4. Boyd WD, Kiaii B, Novick RJ, et al. RAVECAB: improving outcome in off-pump minimal access surgery with robotic assistance and video enhancement. Can J Surg, 2001, 44(1): 45-50.
5. Geva T, Martins JD, Wald RM. Atrial septal defects. Lancet, 2014, 383(9932): 1921-1932.
6. Gao C, Yang M, Wang G, et al. Totally endoscopic robotic ventricular septal defect repair. Innovations (Phila), 2010, 5(4): 278-280.
7. Colson PH, Gaudard P, Fellahi JL, et al. Active bleeding after cardiac surgery: a prospective observational multicenter study. PLoS One, 2016, 11(9): e0162396.
8. Chelemer SB, Prato BS, Cox PM Jr, et al. Association of bacterial infection and red blood cell transfusion after coronary artery bypass surgery. Ann Thorac Surg, 2002, 73(1): 138-142.
9. Chamberland ME. Emerging infectious agents: do they pose a risk to the safety of transfused blood and blood products? Clin Infect Dis, 2002, 34(6): 797-805.
10. 陈峙公, 尤涛, 王子政, 等. 心外科胸腔镜与机器人辅助手术结局指标的比较. 腹腔镜外科杂志, 2018, 23(12): 923-926.
11. Yu HY, Friedlander DF, Patel S, et al. The current status of robotic oncologic surgery. CA Cancer J Clin, 2013, 63(1): 45-56.
12. Hu LD, Li XF, Wang XY, et al. Robotic versus laparoscopic gastrectomy for gastric carcinoma: a meta-analysis of efficacy and safety. Asian Pac J Cancer Prev, 2016, 17(9): 4327-4333.
13. Cui Y, Li C, Xu Z, et al. Robot-assisted versus conventional laparoscopic operation in anus-preserving rectal cancer: a meta-analysis. Ther Clin Risk Manag, 2017, 13: 1247-1257.
14. Li X, Wang T, Yao L, et al. The safety and effectiveness of robot-assisted versus laparoscopic TME in patients with rectal cancer: A meta-analysis and systematic review. Medicine (Baltimore), 2017, 96(29): e7585.
15. Gong W, Cai J, Wang Z, et al. Robot-assisted coronary artery bypass grafting improves short-term outcomes compared with minimally invasive direct coronary artery bypass grafting. J Thorac Dis, 2016, 8(3): 459-468.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of robot-assisted surgery system versus total thoracoscopy for atrial septal defect repair on a beating heart

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