Factors Associated With Chest Tube Output Following Robotic Totally Endoscopic Coronary Artery Bypass Grafting

Data on chest tube output following robotic totally endoscopic coronary artery bypass grafting (TECAB) are limited. We aimed to quantify chest tube drainage following robotic TECAB and identify factors associated with increased output.

A total of 125 consecutive patients undergoing robotic TECAB from September 2021 to July 2025 were retrospectively analyzed. Chest tube output was recorded over 96 h postoperatively. Univariable and multivariable linear regression analyses were performed to identify predictors of increased drainage.

Median chest tube output over 4 days was 945 mL (interquartile range: 703 to 1,400 mL). Median chest tube duration was 3 (2 to 4) days. Drainage volumes were lower than those reported for open coronary artery bypass grafting (CABG) and comparable with mixed robotic cardiac surgery cohorts. Increased chest tube output correlated positively with the number of transfused red blood cell units (r_s = 0.336, P < 0.001) and the number of postoperative chest radiographs (r_s = 0.378, P < 0.001). On multivariable regression analysis, age (B = 14.2 mL/year, P = 0.049), male sex (B = 353 mL, P = 0.037), and longer procedure time (B = 1.6 mL/min, P = 0.019) were independent factors associated with increased output.

Chest tube output after robotic TECAB appears comparable with values reported in mixed robotic cardiac surgery and lower than those reported for open CABG. Operative strategy including single versus multivessel TECAB, arrested versus beating heart, and hybrid coronary revascularization did not significantly influence output. Chest tube output after robotic TECAB was driven by age, gender, and procedure time, and higher output was associated with higher resource use.