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用于房间隔缺损封堵的微创开胸手术与正中胸骨切开术:微创开胸手术应作为标准技术应用吗?

Mini-thoracotomy versus median sternotomy for atrial septal defect closure: Should mini-thoracotomy be applied as a standard technique?

作者信息

Beşir Yüksel, Gökalp Orhan, Karaağaç Ertürk, Eygi Börteçin, İner Hasan, Yeşilkaya Nihan, Peker İhsan, Yılık Levent, Gürbüz Ali

机构信息

Department of Cardiovascular Surgery, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey.

Department of Cardiovascular Surgery, Adıyaman State Hospital, Adıyaman, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jun 17;27(3):280-285. doi: 10.5606/tgkdc.dergisi.2019.17243. eCollection 2019 Jul.

Abstract

BACKGROUND

This study aims to compare outcomes of minithoracotomy versus median sternotomy for atrial septal defect closure.

METHODS

Between January 2012 and May 2017, a total of 44 patients (8 males, 36 females; mean age 33.86 years; range, 14 to 63 years) who underwent atrial septal defect repair through mini-thoracotomy or median sternotomy in our clinic were retrospectively analyzed. Pre-, intra-, and postoperative data of the patients were recorded.

RESULTS

There was no significant difference in the cardiopulmonary bypass and cross-clamp times between the groups, although the duration of operation was shorter in the mini-thoracotomy group (p=0.001). No significant difference was observed between the groups in terms of early mortality, neurological complications, and residual atrial septal defect. The mean mechanical ventilation time and length of intensive care unit and hospital stay were statistically significantly shorter, and the amount of bleeding was statistically significantly lower in the mini-thoracotomy group (p=0.001 for all).

CONCLUSION

Mini-thoracotomy should be kept in mind as a favorable alternative to sternotomy following a satisfactory learning curve period with less cost and higher patient benefit.

摘要

背景

本研究旨在比较微创开胸手术与正中开胸手术治疗房间隔缺损的效果。

方法

回顾性分析2012年1月至2017年5月间在我院通过微创开胸手术或正中开胸手术进行房间隔缺损修复的44例患者(8例男性,36例女性;平均年龄33.86岁;范围14至63岁)。记录患者术前、术中和术后的数据。

结果

两组之间体外循环和主动脉阻断时间无显著差异,尽管微创开胸手术组的手术时间较短(p = 0.001)。两组在早期死亡率、神经并发症和残余房间隔缺损方面无显著差异。微创开胸手术组的平均机械通气时间、重症监护病房停留时间和住院时间在统计学上显著缩短,出血量在统计学上显著减少(均p = 0.001)。

结论

在经历一段令人满意的学习曲线期后,微创开胸手术应被视为开胸手术的一种有利替代方案,其成本更低且对患者益处更大。

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