Department of Cardiac Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong,
Ann Thorac Surg. 2011 Dec;92(6):2230-4. doi: 10.1016/j.athoracsur.2011.07.053. Epub 2011 Oct 10.
Quality of life in patients undergoing totally thoracoscopic closure of atrial septal defect is unclear.
Thoracoscopic atrial septal defect repair was performed in 96 patients (37 males, aged 19.4 ± 8.7 years) without the aid of a computerized robotic surgical system. An additional 56 patients (23 males, aged 21.0 ± 16.1 years) undergoing conventional atrial septal defect closure through sternotomy were enrolled as a control group. Quality of life was assessed with the Medical Outcomes Study Short Form Survey on day 60 after surgery.
Atrial septal defect closure was successful in all patients. There was no perioperative mortality or reoperation for bleeding. Total duration of operations (98 ± 11 versus 128 ± 21 minutes, p < 0.01) and hospital stays (5.3 ± 1.7 versus 6.9 ± 2.1 days, p = 0.024) were shorter in the study group than in the control group, respectively. At discharge, patients with moderate to severe incisional pain in the study and control groups was 11.6% and 62.5%, respectively (p = 0.008). The time interval between discharge and returning to school or work in the study group was shorter than in the control group (28 ± 4 versus 42 ± 7 days, p = 0.003). The mean scores of eight variables in the Short Form Survey, such as physical function, bodily pain, social function, and general or mental health in the study group were higher than in the control group (p < 0.05 or p < 0.01).
Compared with conventional sternotomy, totally thoracoscopic atrial septal defect closure was associated with a faster recovery of physical function and a better quality of life.
完全胸腔镜下房间隔缺损修补术患者的生活质量尚不清楚。
在没有计算机化机器人手术系统辅助的情况下,对 96 例(男 37 例,年龄 19.4 ± 8.7 岁)患者行胸腔镜房间隔缺损修补术。另外 56 例(男 23 例,年龄 21.0 ± 16.1 岁)经胸骨切开术行传统房间隔缺损修补术的患者作为对照组。术后 60 天采用医疗结局研究短式量表调查生活质量。
所有患者均成功关闭房间隔缺损。无围手术期死亡或因出血再次手术。研究组的总手术时间(98 ± 11 比 128 ± 21 分钟,p < 0.01)和住院时间(5.3 ± 1.7 比 6.9 ± 2.1 天,p = 0.024)均短于对照组。出院时,研究组和对照组中度至重度切口疼痛的患者分别为 11.6%和 62.5%(p = 0.008)。研究组出院后重返学校或工作的时间间隔短于对照组(28 ± 4 比 42 ± 7 天,p = 0.003)。研究组短式量表中 8 个变量(如身体功能、躯体疼痛、社会功能和一般或精神健康)的平均评分均高于对照组(p < 0.05 或 p < 0.01)。
与传统胸骨切开术相比,完全胸腔镜下房间隔缺损修补术可更快恢复身体功能,提高生活质量。