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KMID : 0364020080410050598
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Korean Journal of Thoracic and Cardiovascular Surgery
2008 Volume.41 No. 5 p.598 ~ p.604
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Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery
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Lee Young-Ok
Cho Joon-Yong
Lee Jong-Tae
Kim Gun-Jik
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Abstract
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Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach.
Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups.
Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative (292.7±61.7 and 264.0±47.9 min, respectively; p=0.01) and CPB times (128.4±37.6 and 101.7±32.5 min, respectively; p＜0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times (82.1±35.0 and 87.8±113.5 min, respectively; p=0.74) and ventilator times (18.0±18.4 and 19.7±9.7 hr, respectively; p=0.57) between the groups. The stay on the ICU (53.2±40.2 and 72.8±42.1 hr, respectively; p=0.02) and the hospitalization time (9.7±7.2 and 14.8±11.9 days, respectively; p=0.01) were shorter for group A. The patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pain score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral (0.7±1.0 and 0.9±0.9, respectively; p=0.60) and tricuspid regurgitation (1.0±0.9 and 1.1±1.0, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group.
Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that’s done through a median sternotomy.
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KEYWORD
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Robotics, Minimally invasive surgery, Cardiac surgery
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