电视辅助胸腔镜下动脉导管未闭夹闭术：接近金标准且是经皮技术的微创竞争方法。

Video-assisted thoracoscopic clipping of patent ductus arteriosus: close to the gold standard and minimally invasive competitor of percutaneous techniques.

作者信息

Villa Emmanuel, Folliguet Thierry, Magnano Diego, Vanden Eynden Frédéric, Le Bret Emmanuel, Laborde François

机构信息

Cardiac Pathology Department, Institut Mutualiste Montsouris, Paris, France.

出版信息

J Cardiovasc Med (Hagerstown). 2006 Mar;7(3):210-5. doi: 10.2459/01.JCM.0000215275.55144.17.

DOI:10.2459/01.JCM.0000215275.55144.17

PMID:16645388

Abstract

OBJECTIVE

To review our 12-year experience in video-assisted thoracoscopic surgery (VATS) for patent ductus arteriosus.

METHODS

VATS was performed in 743 patients. Three groups were compared: 24 low-birth-weight infants (LBWIs), 676 children between 2.5-25 kg and 43 boys > 25 kg. A diameter of > 8 mm was the main contraindication. For 85 consecutive patients, hospital stay underwent cost analysis.

RESULTS

Median age was 1.6 years (range 5 days-33 years) and median weight 9.0 kg (range 1.2-65 kg). Mortality was nil. Median operative time was 20 min and hospital stay 2 days. Residual patency at discharge was 0% in LBWIs, 0.7% in children, and 4.7% in boys (P = NS) and 0, 0.3, and 4.7% at follow-up (P = 0.001). Persistent recurrent laryngeal nerve dysfunction was recorded in 4.2% of LBWIs, 0.3% of children and 0% of boys (P = 0.012). Total mean cost was Euro 5954 +/- 2110.

CONCLUSIONS

The success rate of VATS clipping compares favorably with the thoracotomic approach but without chest wall trauma and it may have a very favorable cost-effective therapeutic balance compared to transcatheter techniques.

摘要

目的

回顾我们12年来使用电视辅助胸腔镜手术（VATS）治疗动脉导管未闭的经验。

方法

对743例患者进行了VATS手术。比较了三组：24例低体重婴儿（LBWI）、676例体重在2.5 - 25 kg之间的儿童和43例体重>25 kg的男孩。主要禁忌证为直径>8 mm。对连续85例患者的住院情况进行了成本分析。

结果

中位年龄为1.6岁（范围5天至33岁），中位体重9.0 kg（范围1.2至65 kg）。死亡率为零。中位手术时间为20分钟，住院时间为2天。出院时LBWI的残余通畅率为0%，儿童为0.7%，男孩为4.7%（P =无显著性差异），随访时分别为0%、0.3%和4.7%（P = 0.001）。持续性喉返神经功能障碍在LBWI中的发生率为4.2%，儿童为0.3%，男孩为0%（P = 0.012）。总平均费用为5954欧元±2110欧元。