Temizkan Veysel, Arslan Gokhan, Ugur Murat, Alp Ibrahim, Yedekci Erturk, Ucak Alper, Tas Dilaver, Yilmaz Ahmet Turan
Department of Cardiovascular Surgery, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
Thorac Cardiovasc Surg. 2013 Apr;61(3):209-14. doi: 10.1055/s-0032-1333203. Epub 2013 Jan 23.
In this study, cardiac surgery with minimally invasive reversed C sternotomy was compared with conventional sternotomy in patients undergoing valve replacement or septal defect repair.
In this prospective randomized study, 35 patients were assigned into one of two groups for elective cardiac surgery under general anesthesia: Group A (reversed C sternotomy group) and Group B (conventional sternotomy group). Intraoperative variables, intubation time, postoperative drainage volume, pulmonary function tests, sleep quality and quality of life, and requirement for blood transfusion were compared.
A significant difference between the two groups was found in blood transfusion requirement, extubation time, and drainage volume. Forced expiratory volume in one second and functional vital capacity were significantly lower in Group B than in Group A at postoperative Month 1. Total sleep component score of Pittsburg Sleep Quality Index in Group B patients was significantly worse at postoperative Month 1. Postoperative assessment of quality of life (physical and mental) also showed a significant difference between the two groups.
These preliminary findings suggest that creating an access point without compromising the integrity of the sternum seems to be an advantageous and appropriate technique for suitable patients undergoing cardiac surgery.
在本研究中,对接受瓣膜置换或间隔缺损修复的患者,比较了采用微创倒C形胸骨切开术的心脏手术与传统胸骨切开术。
在这项前瞻性随机研究中,35例患者在全身麻醉下被分配到两组之一进行择期心脏手术:A组(倒C形胸骨切开术组)和B组(传统胸骨切开术组)。比较术中变量、插管时间、术后引流量、肺功能测试、睡眠质量和生活质量以及输血需求。
两组在输血需求、拔管时间和引流量方面存在显著差异。术后第1个月,B组的一秒用力呼气量和功能肺活量显著低于A组。B组患者术后第1个月匹兹堡睡眠质量指数的总睡眠成分评分显著更差。术后生活质量(身体和心理)评估也显示两组之间存在显著差异。
这些初步研究结果表明,对于适合的心脏手术患者,在不损害胸骨完整性的情况下创建一个入路点似乎是一种有利且合适的技术。