Abstract：
UNASSIGNED: Cardiac sympathetic denervation (CSD) is a surgical antiadrenergic procedure that can reduce sustained ventricular tachyarrhythmia (VT). Video-assisted thoracoscopic surgery (VATS) is currently the standard approach used in CSD, and the practicality for robot-assisted thoracoscopic surgery (RATS) has yet to be investigated.
UNASSIGNED: We conducted a single-center retrospective study of all adult patients (N = 67) who underwent CSD from 2015 to 2021. We compared short-term outcomes of those treated with RATS versus VATS thoracic sympathectomy. For patients with VT, we examined the effectiveness of a RATS approach in reducing implantable cardioverter defibrillator (ICD) shock burden.
UNASSIGNED: A total of 34 patients underwent RATS cardiac denervation, and 33 underwent VATS cardiac denervation. Those undergoing RATS denervation had a significantly shorter procedure duration with a median of 129 min (P = 0.008). Patients receiving the VATS approach were significantly more complicated by pneumothorax (P = 0.004) and overall complications (P = 0.01) when compared with the RATS approach. At 1 year after surgery, both groups had significant reductions in ICD shocks compared with before surgery, both decreasing from a median of 4 to 0 shocks (P < 0.001). In addition, at 1 year after surgery, the percentage of patients with persistent ICD shocks and the median of ICD shocks were similar between the groups.
UNASSIGNED: The RATS approach to cardiac denervation has similar 1-year follow-up outcomes in reducing recurrent VT as the VATS approach. However, patients undergoing RATS denervation experienced better perioperative outcomes. This shows promise for robotic CSD to be an effective and safe therapeutic option for patients with malignant arrhythmias.
UNASSIGNED: We conducted a single-center retrospective study of all adult patients (N = 67) who underwent CSD from 2015 to 2021. We compared short-term outcomes of those treated with RATS versus VATS thoracic sympathectomy. For patients with VT, we examined the effectiveness of a RATS approach in reducing implantable cardioverter defibrillator (ICD) shock burden.
UNASSIGNED: A total of 34 patients underwent RATS cardiac denervation, and 33 underwent VATS cardiac denervation. Those undergoing RATS denervation had a significantly shorter procedure duration with a median of 129 min (P = 0.008). Patients receiving the VATS approach were significantly more complicated by pneumothorax (P = 0.004) and overall complications (P = 0.01) when compared with the RATS approach. At 1 year after surgery, both groups had significant reductions in ICD shocks compared with before surgery, both decreasing from a median of 4 to 0 shocks (P < 0.001). In addition, at 1 year after surgery, the percentage of patients with persistent ICD shocks and the median of ICD shocks were similar between the groups.
UNASSIGNED: The RATS approach to cardiac denervation has similar 1-year follow-up outcomes in reducing recurrent VT as the VATS approach. However, patients undergoing RATS denervation experienced better perioperative outcomes. This shows promise for robotic CSD to be an effective and safe therapeutic option for patients with malignant arrhythmias.
摘要：
■心脏交感神经支配术（CSD）是一种外科抗肾上腺素能手术，可以减少持续的室性快速性心律失常（VT）。电视胸腔镜手术（VATS）是目前CSD中使用的标准方法，机器人辅助胸腔镜手术（RATS）的实用性尚待研究。
■我们对2015年至2021年接受CSD的所有成年患者（N=67）进行了单中心回顾性研究。我们比较了接受RATS和VATS胸交感神经切除术的患者的短期预后。对于室性心动过速患者，我们研究了RATS方法在降低植入式心律转复除颤器(ICD)休克负担方面的有效性.
■共有34例患者接受了大鼠心脏去神经,33人接受了VATS心脏神经支配术。那些接受大鼠神经支配的患者的手术持续时间明显较短，中位数为129分钟（P=0.008）。与RATS方法相比，接受VATS方法的患者气胸（P=0.004）和总体并发症（P=0.01）明显更复杂。手术后1年,与手术前相比，两组的ICD电击均显著减少，两者都从4次冲击的中位数下降到0次(P<0.001)。此外,手术后一年，两组间持续ICD电击的患者百分比和ICD电击的中位数相似.
■与VATS方法相比，RATS方法心脏神经支配术在减少复发性室性心动过速方面具有相似的1年随访结果。然而,接受RATS去神经支配的患者围手术期结局较好.这表明机器人CSD有望成为恶性心律失常患者的有效且安全的治疗选择。
■我们对2015年至2021年接受CSD的所有成年患者（N=67）进行了单中心回顾性研究。我们比较了接受RATS和VATS胸交感神经切除术的患者的短期预后。对于室性心动过速患者，我们研究了RATS方法在降低植入式心律转复除颤器(ICD)休克负担方面的有效性.
■共有34例患者接受了大鼠心脏去神经,33人接受了VATS心脏神经支配术。那些接受大鼠神经支配的患者的手术持续时间明显较短，中位数为129分钟（P=0.008）。与RATS方法相比，接受VATS方法的患者气胸（P=0.004）和总体并发症（P=0.01）明显更复杂。手术后1年,与手术前相比，两组的ICD电击均显著减少，两者都从4次冲击的中位数下降到0次(P<0.001)。此外,手术后一年，两组间持续ICD电击的患者百分比和ICD电击的中位数相似.
■与VATS方法相比，RATS方法心脏神经支配术在减少复发性室性心动过速方面具有相似的1年随访结果。然而,接受RATS去神经支配的患者围手术期结局较好.这表明机器人CSD有望成为恶性心律失常患者的有效且安全的治疗选择。
