title: Robotic coronary artery bypass grafting decreases 30-day complication rate, length of stay, and acute care facility discharge rate compared with conventional surgery.
abstract: OBJECTIVE
  The objective of this study was to compare the short-term outcomes of robotic with conventional on-pump coronary artery bypass grafting (CABG).
  
  
  METHODS
  The study population included 2091 consecutive patients who underwent either conventional or robotic CABG from January 2007 to March 2012. Preoperative, intraoperative, and 30-day postoperative variables were collected for each group. To compare the incidence of rapid recovery between conventional and robotic CABG, the surrogate variables of early discharge and discharge to home (vs rehabilitation or acute care facility) were evaluated. A multivariate logistic regression analysis was used.
  
  
  RESULTS
  One hundred fifty robotic and 1619 conventional CABG cases were analyzed. Multivariate logistic regression analysis demonstrated that robotic surgery was a strong predictor of lower 30-day complications [odds ratio (OR), 0.24; P = 0.005], short length of stay (OR, 3.31; P < 0.001), and decreased need for an acute care facility (OR, 0.55; P = 0.032). In the presence of complications (New York State Complication Composite), the robotic technique was not associated with a change in discharge status.
  
  
  CONCLUSIONS
  In this retrospective review, robotic CABG was associated with a lower 30-day complication rate, a shorter length of stay, and a lower incidence of acute care facility discharge than conventional on-pump CABG. It may suggest a more rapid recovery to preoperative status after robotic surgery; however, only a randomized prospective study could confirm the advantages of a robotic approach.
authors.affiliation: From the *Department of Anesthesiology, †Department of Cardiovascular and Thoracic Surgery, and ‡Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Galina
authors.initials: G
authors.lastname: Leyvi
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forest
authors.forename: Vankeepuram S
authors.initials: VS
authors.lastname: Srinivas
authors.forename: Mark
authors.initials: M
authors.lastname: Greenberg
authors.forename: Nan
authors.initials: N
authors.lastname: Wang
authors.forename: Alec
authors.initials: A
authors.lastname: Mais
authors.forename: Max J
authors.initials: MJ
authors.lastname: Snyder
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: DeRose
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009518:New York; D009735:Nursing Homes / Q000706:statistics & numerical data; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*