Clinical Comparison Of Da Vinci Robot Assisted And Conventional Thoracotomy With Mitral Valvuloplasty

Objective To compare the clinical effects of Da Vinci robotic assisted and conventional thoracotomy with mitral valvuloplasty,and to further clarify the advantages and disadvantages of the Da Vinci robotic surgery system in mitral valvuloplasty,for the Da Vinci robotic surgery system.Applications in cardiac surgery provide some data support and improved direction.Methods A total of 116 patients with mitral valvuloplasty were enrolled from November 2014 to July 2018 in the Affiliated Hospital of Qingdao University.Among them,38 were assisted by mitral valvuloplasty,named robot group.78 cases of thoracic mitral valvuloplasty were named as open chest group.Preoperative data were collected from the two groups,including: age,gender,BMI,biochemical test results,past medical history(including diabetes,hypertension,etc.);intraoperative data: operative time,cardiopulmonary bypass time,aortic occlusion time,Hemorrhage volume,autologous blood transfusion and allogeneic blood transfusion;postoperative data: blood transfusion volume,ICU time,tracheal intubation time,hospitalization time,incidence of complications,etc.,as well as symptom improvement of the two groups of patients,were divided into improvement No improvement or aggravation;at the same time,the left atrial size,left ventricular size,pulmonary artery pressure,ejection fraction,mitral valve orifice size,reflux area,and reflux beam velocity in preoperative and postoperative echocardiography in 116 patients The degree of reflux was compared.The SPSS software and statistical methods were used to analyze whether there was any difference between the two groups of patients,and the difference was not statistically significant(P value was greater than or less than 0.05).Results The Da Vinci group and the conventional group had satisfactory surgical results,no hospital deaths,and were discharged after improvement.None of the patients in the Da Vinci group were converted to a middle chest.There were no significant differences in gender,age,BMI,and past medical history between the two groups(P>0.05).The total operative time,transit time,and aortic occlusion time in the Da Vinci group were longer than those in the conventional group(see Table 3),and the difference was statistically significant(P< 0.05).The thoracic drainage,transfusion volume,ICU time,postoperative tracheal intubation time,and postoperative hospital stay were significantly lower in the Da Vinci group than in the conventional group(see Table 4).The difference was statistically significant(P< 0.05).In the Da Vinci group and the conventional group,postoperative echocardiography showed improvement in left atrial,left ventricular,pulmonary artery pressure,and ejection fraction compared with preoperative,and the degree of reflux was significantly improved(P< 0.05).Statistical differences(P>0.05).There was no significant difference in the incidence of postoperative pulmonary infection between the two groups(P>0.05).In the Da Vinci group,1 case complicated with deep venous thrombosis of the lower extremity was more common than the conventional group(P< 0.05).The incidence of postoperative pleural effusion,malignant arrhythmia and wound infection was higher in the conventional group than in the Da Vinci group.(P<0.05).Conclusion The Da Vinci robotic surgical system can be safely and effectively applied in mitral valvuloplasty,and can significantly shorten the time of tracheal intubation,ICU time and postoperative hospital stay,and reduce the amount of postoperative blood transfusion and postoperative drainage.And the incidence of postoperative complications,is a good choice for minimally invasive surgery,but it has a certain learning curve,surgery time,transit time and aortic occlusion time is longer than the middle open chest group,but with the case As the number increases,the above situation will be a downward trend.