Jun Tae-Gook, Park Pyo Won, Lee Young Tak, Park Kay-Hyun, Sung Kiick, Kang I Seok, Lee Heung Jae
Department of Thoracic and Cardiovascular Surgery, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, 50 IL Won-Dong, Kangnam-Ku, Seoul 135-230, South Korea.
Cardiovasc Surg. 2002 Dec;10(6):595-9. doi: 10.1016/s0967-2109(02)00065-0.
The purpose of this paper is to analyze the feasibility of the full sternotomy with minimal skin incision and its related complications and risks.
A total of 405 patients with simple congenital heart disease underwent open heart surgery exclusively under full sternotomy with minimal skin incision. We reviewed the available medical records of the patients retrospectively. Bypass time, aorta cross clamp time, and period of hospital stay were compared with the control group (223 patients with standard long skin incision).
Full sternotomy with minimal skin incision provided adequate surgical views and successful repair was done in all patients. There was no mortality. One patient had chylopericardium after the operation and another patient had a postoperative bleeding at the sternum. Minimal skin incision took the similar aorta cross-clamp time and total cardiopulmonary bypass time compared with full skin incision in atrial septal defect patients. Among the ventricular septal defect patients, minimal skin incision took a little longer aorta cross-clamp time (10%), but similar total cardiopulmonary bypass time compared with full skin incision.
Minimal skin incision with full sternotomy provides improved cosmetic results. There was no increased mortality and morbidity using minimal access. It can be applied to more complex congenital heart disease contrast to other minimal invasive techniques for atrial septal defect.
本文旨在分析全胸骨切开术并采用最小皮肤切口的可行性及其相关并发症和风险。
共有405例单纯先天性心脏病患者仅在全胸骨切开术并采用最小皮肤切口的情况下接受了心脏直视手术。我们对患者的现有病历进行了回顾性分析。将体外循环时间、主动脉阻断时间和住院时间与对照组(223例采用标准长皮肤切口的患者)进行比较。
全胸骨切开术并采用最小皮肤切口提供了足够的手术视野,所有患者均成功完成修复。无死亡病例。1例患者术后发生乳糜心包,另1例患者胸骨术后出血。在房间隔缺损患者中,与全皮肤切口相比,最小皮肤切口的主动脉阻断时间和总体外循环时间相似。在室间隔缺损患者中,与全皮肤切口相比,最小皮肤切口的主动脉阻断时间稍长(10%),但总体外循环时间相似。
全胸骨切开术并采用最小皮肤切口可改善美容效果。采用微创方法并未增加死亡率和发病率。与其他房间隔缺损的微创技术相比,它可应用于更复杂的先天性心脏病。