title: Association of Robotic Totally Endoscopic Coronary Artery Bypass Graft Surgery Associated With a Preliminary Cardiac Enhanced Recovery After Surgery Program: A Retrospective Analysis.
abstract: OBJECTIVE
  The robotic totally endoscopic coronary artery bypass graft (TECAB) surgery reduces patients' recovery time. The present trial investigated the feasibility and safety of an initial enhanced recovery after surgery (ERAS) path for patients undergoing robotic beating-heart TECAB and compared it with both conventional surgery and traditional perioperative care. It was hypothesized that the preliminary ERAS pathway associated with a beating-heart TECAB procedure could have a synergistic effect on postoperative patient care.
  
  
  METHODS
  Observational retrospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients scheduled for coronary artery bypass graft and undergoing robotic beating-heart TECAB (n = 38) were compared with those undergoing standard surgery and perioperative care (n = 33). The outcomes were the possibility of tracheal extubation at the end of the surgery and the incidence of postoperative complications.
  
  
  RESULTS
  The main comorbidities were similar between the 2 groups. Extubation on the operating table in the TECAB group was possible in all cases without requiring prompt endotracheal tube reinsertion. The proportion of patients transfused was significantly lower in the TECAB group (p = 0.009). In addition, the duration of intensive care unit and hospital stay were reduced significantly by 24 hours and by 4 days, respectively, in the TECAB group compared with the standard group (p< 0.05).
  
  
  CONCLUSIONS
  The present results suggested that a program coupling a beating-heart TECAB with a preliminary ERAS path for patients requiring a single coronary revascularization is feasible and safe. This approach could reduce postoperative mechanical ventilation time, transfusion rate, and both intensive care unit and hospital stay.
authors.affiliation: CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France. Electronic address: cedrick.zaouter@gmail.com.
authors.forename: Cédrick
authors.initials: C
authors.lastname: Zaouter
authors.affiliation: CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France; University Bordeaux, Adaptation Cardiovasculaire à l'ischémie, Pessac, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Imbault
authors.affiliation: CHU de Bordeaux, Service de Chirurgie Cardiaque et Vasculaire, Bordeaux, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Labrousse
authors.affiliation: CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Abdelmoumen
authors.affiliation: CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Coiffic
authors.affiliation: CHU de Bordeaux, Service de Chirurgie Cardiaque et Vasculaire, Bordeaux, France.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Colonna
authors.affiliation: Hôpital Erasme Europe Hospitals, Service de Chirurgie Cardiaque, Brussels, Belgium.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Jansens
authors.affiliation: CHU de Bordeaux, Service d'Anesthésie-Réanimation II, Bordeaux, France; University Bordeaux, Adaptation Cardiovasculaire à l'ischémie, Pessac, France; INSERM U1034, Adaptation cardiovasculaire à l'ischémie, Pessac, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Ouattara
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*
keywords: cardiac anesthesia; enhanced recovery after surgery; mini-invasive surgery; robotic surgery; totally endoscopic coronary artery bypass graft; ultrafast-track anesthesia