Cédrick Zaouter1, Julien Imbault2, Louis Labrousse3, Youssef Abdelmoumen4, Alain Coiffic4, Giorgio Colonna3, Jean-Luc Jansens5, Alexandre Ouattara6. 1. CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France. Electronic address: cedrick.zaouter@gmail.com. 2. CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France; University Bordeaux, Adaptation Cardiovasculaire à l'ischémie, Pessac, France. 3. CHU de Bordeaux, Service de Chirurgie Cardiaque et Vasculaire, Bordeaux, France. 4. CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France. 5. Hôpital Erasme Europe Hospitals, Service de Chirurgie Cardiaque, Brussels, Belgium. 6. CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France; University Bordeaux, Adaptation Cardiovasculaire à l'ischémie, Pessac, France; INSERM U1034, Adaptation cardiovasculaire à l'ischémie, Pessac, France.
Abstract
OBJECTIVES: The robotic totally endoscopic coronary artery bypass graft (TECAB) surgery reduces patients' recovery time. The present trial investigated the feasibility and safety of an initial enhanced recovery after surgery (ERAS) path for patients undergoing robotic beating-heart TECAB and compared it with both conventional surgery and traditional perioperative care. It was hypothesized that the preliminary ERAS pathway associated with a beating-heart TECAB procedure could have a synergistic effect on postoperative patient care. DESIGN: Observational retrospective study. SETTING: University hospital. PARTICIPANTS: Patients scheduled for coronary artery bypass graft and undergoing robotic beating-heart TECAB (n = 38) were compared with those undergoing standard surgery and perioperative care (n = 33). The outcomes were the possibility of tracheal extubation at the end of the surgery and the incidence of postoperative complications. MEASUREMENTS AND MAIN RESULTS: The main comorbidities were similar between the 2 groups. Extubation on the operating table in the TECAB group was possible in all cases without requiring prompt endotracheal tube reinsertion. The proportion of patients transfused was significantly lower in the TECAB group (p = 0.009). In addition, the duration of intensive care unit and hospital stay were reduced significantly by 24 hours and by 4 days, respectively, in the TECAB group compared with the standard group (p< 0.05). CONCLUSIONS: The present results suggested that a program coupling a beating-heart TECAB with a preliminary ERAS path for patients requiring a single coronary revascularization is feasible and safe. This approach could reduce postoperative mechanical ventilation time, transfusion rate, and both intensive care unit and hospital stay.
OBJECTIVES: The robotic totally endoscopic coronary artery bypass graft (TECAB) surgery reduces patients' recovery time. The present trial investigated the feasibility and safety of an initial enhanced recovery after surgery (ERAS) path for patients undergoing robotic beating-heart TECAB and compared it with both conventional surgery and traditional perioperative care. It was hypothesized that the preliminary ERAS pathway associated with a beating-heart TECAB procedure could have a synergistic effect on postoperative patient care. DESIGN: Observational retrospective study. SETTING: University hospital. PARTICIPANTS: Patients scheduled for coronary artery bypass graft and undergoing robotic beating-heart TECAB (n = 38) were compared with those undergoing standard surgery and perioperative care (n = 33). The outcomes were the possibility of tracheal extubation at the end of the surgery and the incidence of postoperative complications. MEASUREMENTS AND MAIN RESULTS: The main comorbidities were similar between the 2 groups. Extubation on the operating table in the TECAB group was possible in all cases without requiring prompt endotracheal tube reinsertion. The proportion of patients transfused was significantly lower in the TECAB group (p = 0.009). In addition, the duration of intensive care unit and hospital stay were reduced significantly by 24 hours and by 4 days, respectively, in the TECAB group compared with the standard group (p< 0.05). CONCLUSIONS: The present results suggested that a program coupling a beating-heart TECAB with a preliminary ERAS path for patients requiring a single coronary revascularization is feasible and safe. This approach could reduce postoperative mechanical ventilation time, transfusion rate, and both intensive care unit and hospital stay.
Authors: Christopher Cao; Praveen Indraratna; Mathew Doyle; David H Tian; Kevin Liou; Stine Munkholm-Larsen; Ciska Uys; Sohaib Virk Journal: Ann Cardiothorac Surg Date: 2016-11
Authors: Bei Tian; Chuang Ma; Jin-Wen Su; Jun Luo; Hong-Xia Sun; Jie Su; Zhong-Ping Ning Journal: World J Clin Cases Date: 2022-02-06 Impact factor: 1.337