全机器人腔镜下冠状动脉旁路移植术临床疗效荟萃分析被引量：2

Clinical outcomes of totally endoscopic coronary artery bypass grafting： a system review and meta-analysis

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摘要目的系统评价全机器人腔镜下冠脉旁路移植术（TECABG）的临床疗效。方法系统检索PubMed、Embase、Cochrane Library及相关文章的参考文献，检索自建库至2015年12月13日关于TECAB临床疗效的已发表文献。12项研究纳入最终分析。用R 3.2.3软件进行单个率的荟萃分析。结果TACAB患者住院时间为3.3-8.6 d。近期（围手术期-术后2年）中转开胸率为0-28.1%，吻合口出血率为1.7%-8.5%，住院/术后30 d病死率为0-3.8%，心肌梗死发生率为0-3.4%，脑卒中发生率为0-2.2%；再次血运重建率为0-6.8%，近期桥血管通畅率为89.5%-100%。TECAB患者中期（术后2-5年）生存率为92.7%-100%，再次血运重建率为2.0%-12.2%，中期桥血管通畅率为71.4%-97.0%。结论在选择合适患者的基础上，TECAB是可行、安全及有效的，但目前仍缺少远期结果，在广泛应用于临床之前，仍需大样本的随机对照研究。 Objective To assess the clinical outcomes of totally endoscopic coronary artery bypass grafting （TECABG）. Methods A systematic review of studies reporting clinical outcomes of TECABG was performed. Twelve studies were included in the recta-analysis. R 3.2. 3 was used to perform the statistical analysis. Results Length of hospital stay of TACABG patients ranged from 3.3 to 8.6 days. The rate of recent conversion to thoracotomy was 0 - 28.1% （ from perioperative period to 2 years after surgery） ; the rate of anastomotic bleeding was 1.7% -8.5% ; the case fatality rate of in-hospital or 30 days after surgery was 0 - 3.8% ; the rate of myocardial infarction was 0 - 3.4% ; the rate of stroke was 0 - 2. 2% ; the rate of revascularization was 0 - 6. 8% ; the patency rate of recent coronary artery bypass graft （CABG） was 89. 5% -100%; the mid-time survival rate of TECABG patients （from 2 to 5 years after surgery） was 92. 7% - 100% ; the rate of revascularization was 2. 0% - 12. 2% ; the patency rate of mid-time CABG was 71.4% -97.0%. Conclusions The current data suggests that TECABG is feasible, safe and effective when proper patients are selected. However, randomized controlled trials of TECABG versus conventional CABG are still required due to lack of long-term outcomes.

作者李波王粮山刘长城顾承雄

机构地区首都医科大学附属北京安贞医院心脏外科

出处《中华医学杂志》 CAS CSCD 北大核心 2016年第36期2923-2928,共6页 National Medical Journal of China

基金国家自然科学基金（81370436）

关键词冠状动脉分流术机器人内窥镜治疗结果荟萃分析 Coronary artery bypass Robotics Endoscopes Treatment outcome Meta-analysis

分类号 R654.2 [医药卫生—外科学]

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