Association of Robotic Assistance With Short-term Outcomes After Coronary Artery Bypass Grafting

Annals of thoracic surgery short reports Pub Date : 2025-09-01 DOI:10.1016/j.atssr.2025.03.007

Arjun Verma BS , Justin J. Kim BA , Sara Sakowitz MS, MPH , Yas Sanaiha MD , Joseph Hadaya MD, PhD , Peyman Benharash MD, MS

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引用次数: 0

Abstract

Background

Coronary artery bypass grafting (CABG) is traditionally performed though median sternotomy for multivessel coronary artery disease. Robotic CABG, a viable alternative, comprises less than 1% of CABG procedures in the United States despite its potential benefits. This study aimed to compare the trends and outcomes of conventional and robotic CABG by using a contemporary national cohort.

Methods

A retrospective study was conducted using the 2016 to 2020 Nationwide Readmissions Database (NRD). Adult patients (aged ≥18 years) who underwent single-vessel CABG were identified using International Classification of Diseases, 10th revision procedure codes. Patients were categorized into robotic (totally endoscopic or robotic-assisted) and conventional CABG cohorts. Outcomes evaluated included in-hospital mortality, major adverse events (MAEs), length of stay, hospitalization costs, nonhome discharge, and 30-day readmissions.

Results

Among 21,870 patients, 3433 (15.7%) underwent robotic CABG. The use of robotic CABG increased modestly over the study period. Patients who underwent robotic CABG had lower in-hospital mortality (0.4% vs 1.7%; P < .001) and MAEs (11.4% vs 18.9%; P < .001) compared with conventional CABG. Moreover, the robotic CABG cohort was associated with shorter length of stay and reduced hospitalization costs. After adjusting for baseline characteristics, robotic CABG showed lower odds of in-hospital mortality (adjusted odds ratio, 0.35; 95% CI, 0.15-0.84; P = .019) and MAEs (adjusted odds ratio, 0.72; 95% CI, 0.59-0.88; P = .001).

Conclusions

Robotic CABG is associated with reduced in-hospital mortality, complications, LOS, and hospitalization costs compared with conventional CABG. Despite these benefits, its adoption remains limited, potentially because of the steep learning curve and resource requirements. Further efforts to overcome these barriers could enhance the adoption of robotic CABG and improve patient outcomes.

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机器人辅助与冠状动脉旁路移植术短期预后的关系

背景对于多支冠状动脉疾病，冠状动脉旁路移植术（CABG）传统上是通过胸骨正中切口进行的。机器人CABG是一种可行的替代方案，尽管有潜在的好处，但在美国，它只占CABG手术的不到1%。本研究旨在通过使用当代国家队列来比较传统和机器人CABG的趋势和结果。方法采用2016 - 2020年全国再入院数据库（NRD）进行回顾性研究。接受单血管冠脉搭桥的成年患者（年龄≥18岁）采用国际疾病分类第10版程序代码进行鉴定。患者分为机器人（完全内窥镜或机器人辅助）和传统CABG组。评估的结果包括住院死亡率、主要不良事件（MAEs）、住院时间、住院费用、非家庭出院和30天再入院。结果在21870例患者中，3433例（15.7%）接受了机器人冠脉搭桥。在研究期间，机器人冠状动脉搭桥的使用适度增加。与传统CABG相比，接受机器人CABG的患者住院死亡率（0.4% vs 1.7%; P < 0.001）和MAEs （11.4% vs 18.9%; P < 0.001）较低。此外，机器人CABG队列与更短的住院时间和更低的住院费用相关。在调整基线特征后，机器人CABG显示出较低的院内死亡率（调整优势比0.35;95% CI, 0.15-0.84; P = 0.019）和MAEs（调整优势比0.72;95% CI, 0.59-0.88; P = 0.001）。结论与传统CABG相比，机器人CABG可降低住院死亡率、并发症、LOS和住院费用。尽管有这些好处，但它的采用仍然有限，可能是因为陡峭的学习曲线和资源需求。克服这些障碍的进一步努力可以提高机器人冠脉搭桥的采用，并改善患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of thoracic surgery short reports Surgery

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审稿时长

53 days