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Permanent URI for this collectionhttps://hdl.handle.net/11443/932

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Author: search.filters.author.Alhan, CemSubject: search.filters.subject.cardiac surgery

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    Robotic Cardiac Surgery in Europe: Status 2020
    (FRONTIERS MEDIA SA, 2022-01-01) Cerny, Stepan; Oosterlinck, Wouter; Onan, Burak; Singh, Sandeep; Segers, Patrique; Bolcal, Cengiz; Alhan, Cem; Navarra, Emiliano; Pettinari, Matteo; Van Praet, Frank; De Praetere, Herbert; Vojacek, Jan; Cebotaru, Theodor; Modi, Paul; Doguet, Fabien; Franke, Ulrich; Ouda, Ahmed; Melly, Ludovic; Malapert, Ghislain; Labrousse, Louis; Gianoli, Monica; Agnino, Alfonso; Philipsen, Tine; Jansens, Jean-Luc; Folliguet, Thierry; Palmen, Meindert; Pereda, Daniel; Musumeci, Francesco; Suwalski, Piotr; Cathenis, Koen; van den Eynde, Jef; Bonatti, Johannes; CardioThoracic, European Robotic
    BackgroundEuropean surgeons were the first worldwide to use robotic techniques in cardiac surgery and major steps in procedure development were taken in Europe. After a hype in the early 2000s case numbers decreased but due to technological improvements renewed interest can be noted. We assessed the current activities and outcomes in robotically assisted cardiac surgery on the European continent. MethodsData were collected in an international anonymized registry of 26 European centers with a robotic cardiac surgery program. ResultsDuring a 4-year period (2016-2019), 2,563 procedures were carried out {[}30.0\% female, 58.5 (15.4) years old, EuroSCORE II 1.56 (1.74)], including robotically assisted coronary bypass grafting (n = 1266, 49.4\%), robotic mitral or tricuspid valve surgery (n = 945, 36.9\%), isolated atrial septal defect closure (n = 225, 8.8\%), left atrial myxoma resection (n = 54, 2.1\%), and other procedures (n = 73, 2.8\%). The number of procedures doubled during the study period (from n = 435 in 2016 to n = 923 in 2019). The mean cardiopulmonary bypass time in pump assisted cases was 148.6 (63.5) min and the myocardial ischemic time was 88.7 (46.1) min. Conversion to larger thoracic incisions was required in 56 cases (2.2\%). Perioperative rates of revision for bleeding, stroke, and mortality were 56 (2.2\%), 6 (0.2 \%), and 27 (1.1\%), respectively. Median postoperative hospital length of stay was 6.6 (6.6) days. ConclusionRobotic cardiac surgery case numbers in Europe are growing fast, including a large spectrum of procedures. Conversion rates are low and clinical outcomes are favorable, indicating safe conduct of these high-tech minimally invasive procedures.
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    Robotic Cardiac Surgery in Europe: Status 2020 (vol 8, 827515, 2022)
    (FRONTIERS MEDIA SA, 2022-01-01) Cerny, Stepan; Oosterlinck, Wouter; Onan, Burak; Singh, Sandeep; Segers, Patrique; Bolcal, Cengiz; Alhan, Cem; Navarra, Emiliano; Pettinari, Matteo; Van Praet, Frank; De Praetere, Herbert; Vojacek, Jan; Cebotaru, Theodor; Modi, Paul; Doguet, Fabien; Franke, Ulrich; Ouda, Ahmed; Melly, Ludovic; Malapert, Ghislain; Labrousse, Louis; Gianoli, Monica; Agnino, Alfonso; Philipsen, Tine; Jansens, Jean-Luc; Folliguet, Thierry; Palmen, Meindert; Pereda, Daniel; Musumeci, Francesco; Suwalski, Piotr; Cathenis, Koen; van den Eynde, Jef; Bonatti, Johannes; European Robotic Cardio Throcic Surgeons, E. R. T. C.
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    Use of bone wax is related to increased postoperative sternal dehiscence
    (TERMEDIA PUBLISHING HOUSE LTD, 2014-01-01) Alhan, Cem; Ariturk, Cem; Senay, Sahin; Okten, Murat; Gullu, A. Umit; Kilic, Leyla; Karabulut, Hasan; Toraman, Fevzi
    Aim: To investigate the relation between use of bone wax and postoperative sternal dehiscence after cardiac surgery. Material and methods: Five thousnad three hundred and eighteen consecutive patients who underwent cardiac surgery between 1999 and 2009 were evaluated prospectively. Perioperative use of bone wax, perioperative data and outcome parameters were recorded. Multivariate logistic regression analysis was performed to define independent risk factors for postoperative sternal dehiscence. Results: Bone wax was used in a total of 1151 (21\%) patients. Postoperative sternal dehiscence was detected in 88 (1.6\%) patients. The postoperative sternal dehiscence rate was 1.4\% in patients without bone wax and 2.5\% in patients with bone wax (p = 0.001). The rate of bone wax use was 36.4\% in patients with sternal dehiscence and 21.4\% in patients without sternal dehiscence (p < 0.001). Independent risk factors for postoperative sternal dehiscence were defined as: age > 70 (OR = 1.9, 95\% CI: 1.2-3.1, p = 0.005), chronic obstructive lung disease (OR = 2.4, 95\% CI: 1.5-3.9, p < 0.001), use of bone wax (OR = 1.6, 95\% CI: 1.03-2.5, p = 0.03), nonelective operation (OR = 2, 95\% CI: 1.1-3.4, p = 0.009), and body mass index > 30 (OR = 2.2, 95\% CI: 1.4-3.5, p < 0.001). Conclusions: Our findings suggest that use of bone wax may be associated with increased postoperative sternal dehiscence after cardiac surgery. Thus liberal use of bone wax should be restricted.