机器人辅助心脏外科手术的安全性及中期疗效:一项单中心队列研究OA

Objective:To summarize the clinical efficacy and treatment experience of robot-assisted cardiac surgery.Methods:Clinical data of 31 patients who underwent robot-assisted cardiac surgery using the Da Vinci Xi surgical system at the Department of Cardiovascular Surgery,Xi'an International Medical Center Hospital Affiliated to Northwest University from July 2020 to September 2022 were collected.Perioperative indicators and postoperative follow-up outcomes were analyzed.Results:There were three cases of intraoperative conversion to thoracotomy and two cases of secondary thoracic exploration.Postoperatively,one patient received extracorporeal membrane oxygenation(ECMO)due to severe pulmonary injury,seven patients experienced prolonged mechanical ventilation(＞24 h)due to lung injury,two patients required continuous renal replacement therapy due to renal failure,and 11 patients developed surgery-related liver injury.No surgery-related stroke occurred.One patient died early postoperatively due to low cardiac output syndrome,and the remaining 30 patients were successfully discharged.The maximum follow-up duration was 61 months,and the 1-year and 5-year survival rates were both 93.55％.Conclusion:Robot-assisted cardiac surgery is characterized by minimal invasiveness,safety,reliability,and favorable medium-term prognosis.However,it has a steep learning curve.Prolonged aortic cross-clamp time,cardiopulmonary bypass time,and total operative time can be observed in the initial phase,which tend to decline progressively with accumulated surgical experience.