Fukushima Satsuki, Kakuta Takashi, Fujita Tomoyuki
Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
Kyobu Geka. 2020 Jul;73(7):490-495.
Minimally invasive cardiac surgery (MICS) via mini-right thoracotomy approach has been developed and standardized in the last 30 years, aiming to facilitate postoperative recovery and to minimize surgery-related complications. Mitral regurgitation is the major target of this MICS approach. In our institute, MICS mitral valve repair by direct vision under thoracoscopy guidance has been performed in 139 cases between 2011 and March 2018. Subsequently, robot-assisted surgery program was launched to perform mitral valve repair for 130 patients in the last 2 years. In-hospital and mid-term outcome post-mitral valve repair was not significantly different among sternotomy, MICS direct vision and MICS robot-assist approaches, though there were several pitfalls through the launch of the MICS program. Standardization of the MICS approach of mitral valve repair and other cardiac surgeries was herein summarized and associated pitfalls were explained from surgeons' view.
在过去30年里,通过右胸小切口入路的微创心脏手术(MICS)已得到发展并实现标准化,旨在促进术后恢复并将手术相关并发症降至最低。二尖瓣反流是这种MICS手术方式的主要治疗对象。在我们研究所,2011年至2018年3月期间,已通过胸腔镜引导下直视进行了139例MICS二尖瓣修复手术。随后,在过去两年中启动了机器人辅助手术项目,为130例患者进行二尖瓣修复。二尖瓣修复术后的院内及中期结果在胸骨正中切开术、MICS直视手术和MICS机器人辅助手术方式之间并无显著差异,尽管在MICS项目开展过程中存在一些问题。本文总结了二尖瓣修复及其他心脏手术的MICS手术方式的标准化内容,并从外科医生的角度解释了相关问题。