CAJ | 학술논문

目的：总结达芬奇机器人获取左乳内动脉左前外侧小切口冠状动脉旁路移植术的技术要点，评价手术效果。方法回顾性的分析机器人获取左乳内动脉左前外侧小切口冠脉搭桥手术24例，分析结果并作以总结。结果术后患者均于手术当日顺利脱离呼吸机辅助，机械通气时间5.3±2.8 h，并均于术后18 h 内搬出 ICU。机器人获取乳内动脉时间在40~60 min 左右，术中出血量50 ml 左右，术后引流量较常规手术显著减少，平均90 ml 左右。全组患者无手术死亡和围术期并发症，在随访期间无再发心血管事件，其中11例患者术后复查冠脉 CT，9例接受冠脉造影复查发现桥血管通畅。结论机器人获取左乳内动脉左前外侧小切口搭桥手术的疗效满意，术后恢复快，并发症少，减轻了患者的痛苦，明显减少了死亡率，提高术后生存率。该手术是一项安全、有效的新技术，具有恢复快和美容效果，患者满意度较高。
목적：총결체분기궤기인획취좌유내동맥좌전외측소절구관상동맥방로이식술적기술요점，평개수술효과。방법회고성적분석궤기인획취좌유내동맥좌전외측소절구관맥탑교수술24례，분석결과병작이총결。결과술후환자균우수술당일순리탈리호흡궤보조，궤계통기시간5.3±2.8 h，병균우술후18 h 내반출 ICU。궤기인획취유내동맥시간재40~60 min 좌우，술중출혈량50 ml 좌우，술후인류량교상규수술현저감소，평균90 ml 좌우。전조환자무수술사망화위술기병발증，재수방기간무재발심혈관사건，기중11례환자술후복사관맥 CT，9례접수관맥조영복사발현교혈관통창。결론궤기인획취좌유내동맥좌전외측소절구탑교수술적료효만의，술후회복쾌，병발증소，감경료환자적통고，명현감소료사망솔，제고술후생존솔。해수술시일항안전、유효적신기술，구유회복쾌화미용효과，환자만의도교고。
Objective To investigate the initial experience of da Vinci robotic left internal mammary artery harvesting( LIMA)for coronary artery bypass grafting through small thoracotomy. Methods The ventilation time were 5. 3 ± 2. 8 h,the time staying in ICU were 18 h. The mammary artery harvesting time was 40-60 min,blood loss was about 50 ml and the average of chest tube drainage was 90 ml. There were no operation death and complications. During follow-up,the mammary artery was patent in 11 patients by contrast coronary CT and 9 patients by coronary angiography. Results The quality of the LIMA harvested with robot was good. Less blood loss and faster recovery as well as good cosmetic results were observed. Conclusion Robotic LIMA harvesting was safe and effective,may be related to less blood loss,good LIMA quality and cosmetic effect,faster recovery.