Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients
Abstract Background Excellent partial upper sternotomy outcomes have been reported for patients undergoing aortic surgery, but whether this approach is particularly beneficial to obese patients remains to be established. This study was developed to explore the outcomes of aortic surgical procedures...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-022-01890-y |
| _version_ | 1811257318676889600 |
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| author | Zeng-Rong Luo Yi-Xing Chen Liang-wan Chen |
| author_facet | Zeng-Rong Luo Yi-Xing Chen Liang-wan Chen |
| author_sort | Zeng-Rong Luo |
| collection | DOAJ |
| description | Abstract Background Excellent partial upper sternotomy outcomes have been reported for patients undergoing aortic surgery, but whether this approach is particularly beneficial to obese patients remains to be established. This study was developed to explore the outcomes of aortic surgical procedures conducted via a partial upper sternotomy or a full median sternotomy approach in obese patients. Methods We retrospectively examined consecutive acute type A aortic dissection patients who underwent aortic surgery in our hospital between January 2015 to January 2021. Patients were divided into two groups based on body mass index: ‘non-obese’ and ‘obese’. We then further stratified patients in the obese and non-obese groups into partial upper sternotomy and full median sternotomy groups, with outcomes between these two sternotomy groups then being compared within and between these two body mass index groups. Results In total, records for 493 patients that had undergone aortic surgery were retrospectively reviewed, leading to the identification of 158 consecutive obese patients and 335 non-obese patients. Overall, 88 and 70 obese patients underwent full median sternotomy and partial upper sternotomy, respectively, while 180 and 155 non-obese patients underwent these respective procedures. There were no differences between the full median sternotomy and partial upper sternotomy groups within either BMI cohort with respect to preoperative baseline indicators and postoperative complications. Among non-obese individuals, the partial upper sternotomy approach was associated with reduced ventilation time (P = 0.003), shorter intensive care unit stay (P = 0.017), shorter duration of hospitalization (P = 0.001), and decreased transfusion requirements (Packed red blood cells: P < 0.001; Fresh frozen plasma: P < 0.001). Comparable findings were also evident among obese patients. Conclusions Obese aortic disease patients exhibited beneficial outcomes similar to those achieved for non-obese patients via a partial upper sternotomy approach which was associated with significant reductions in the duration of intensive care unit residency, duration of hospitalization, ventilator use, and transfusion requirements. This surgical approach should thus be offered to aortic disease patients irrespective of their body mass index. |
| first_indexed | 2024-04-12T17:55:29Z |
| format | Article |
| id | doaj.art-4c1f3b130a8444a99b82668423caa3bb |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-12T17:55:29Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-4c1f3b130a8444a99b82668423caa3bb2022-12-22T03:22:22ZengBMCJournal of Cardiothoracic Surgery1749-80902022-05-0117111010.1186/s13019-022-01890-ySurgical outcomes associated with partial upper sternotomy in obese aortic disease patientsZeng-Rong Luo0Yi-Xing Chen1Liang-wan Chen2Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiology, Nan Ping First Hospital Affiliated to Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityAbstract Background Excellent partial upper sternotomy outcomes have been reported for patients undergoing aortic surgery, but whether this approach is particularly beneficial to obese patients remains to be established. This study was developed to explore the outcomes of aortic surgical procedures conducted via a partial upper sternotomy or a full median sternotomy approach in obese patients. Methods We retrospectively examined consecutive acute type A aortic dissection patients who underwent aortic surgery in our hospital between January 2015 to January 2021. Patients were divided into two groups based on body mass index: ‘non-obese’ and ‘obese’. We then further stratified patients in the obese and non-obese groups into partial upper sternotomy and full median sternotomy groups, with outcomes between these two sternotomy groups then being compared within and between these two body mass index groups. Results In total, records for 493 patients that had undergone aortic surgery were retrospectively reviewed, leading to the identification of 158 consecutive obese patients and 335 non-obese patients. Overall, 88 and 70 obese patients underwent full median sternotomy and partial upper sternotomy, respectively, while 180 and 155 non-obese patients underwent these respective procedures. There were no differences between the full median sternotomy and partial upper sternotomy groups within either BMI cohort with respect to preoperative baseline indicators and postoperative complications. Among non-obese individuals, the partial upper sternotomy approach was associated with reduced ventilation time (P = 0.003), shorter intensive care unit stay (P = 0.017), shorter duration of hospitalization (P = 0.001), and decreased transfusion requirements (Packed red blood cells: P < 0.001; Fresh frozen plasma: P < 0.001). Comparable findings were also evident among obese patients. Conclusions Obese aortic disease patients exhibited beneficial outcomes similar to those achieved for non-obese patients via a partial upper sternotomy approach which was associated with significant reductions in the duration of intensive care unit residency, duration of hospitalization, ventilator use, and transfusion requirements. This surgical approach should thus be offered to aortic disease patients irrespective of their body mass index.https://doi.org/10.1186/s13019-022-01890-yAorticObeseBMIMinimally invasivePartial upper sternotomy |
| spellingShingle | Zeng-Rong Luo Yi-Xing Chen Liang-wan Chen Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients Journal of Cardiothoracic Surgery Aortic Obese BMI Minimally invasive Partial upper sternotomy |
| title | Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients |
| title_full | Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients |
| title_fullStr | Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients |
| title_full_unstemmed | Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients |
| title_short | Surgical outcomes associated with partial upper sternotomy in obese aortic disease patients |
| title_sort | surgical outcomes associated with partial upper sternotomy in obese aortic disease patients |
| topic | Aortic Obese BMI Minimally invasive Partial upper sternotomy |
| url | https://doi.org/10.1186/s13019-022-01890-y |
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