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全胸腔镜下心室间隔缺损修补术:单中心经验。

Total thoracoscopic repair of ventricular septal defect: A single-center experience.

机构信息

Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong Province, China.

Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangzhou, China.

出版信息

J Card Surg. 2021 Jul;36(7):2213-2218. doi: 10.1111/jocs.15504. Epub 2021 Mar 30.

Abstract

OBJECTIVES

To explore the safety and efficacy of total thoracoscopic repair of ventricular septal defects (VSD). We compared clinical outcomes of VSD via a total thoracoscopic approach with those of mini-sternotomy.

METHODS

We retrospectively reviewed clinical data from patients with VSD from 2012 to January 2019. According to the surgical pattern, they were divided into two groups: the total thoracoscopic surgery group (36 patients, 27 females, aged 29 ± 9.52 years), and a mini-sternotomy group (31 patients, 12 females, aged 28 ± 8.67 years).

RESULTS

There were no deaths in either group. In the thoracoscopic group, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were significantly longer than those of the mini-sternotomy group (CPB time: 112 ± 23.16 min vs. 78 ± 37.90 min, respectively, p < .001; ACC time: 65 ± 19.94 min vs. 50 ± 24.90 min, respectively, p < .001). postoperative hospital stay time (5.11 ± 2.48 days vs. 5.90 ± 6.27 days, p = .488) and chest drainage (139.86 ± 111.71 ml vs. 196.13 ± 147.34 ml, p = .081) tended to be lower in the thoracoscopy group, although there was no significant difference. No residual shunt or tricuspid regurgitation was found at follow-up.

CONCLUSIONS

Total thoracoscopic repair is safe and effective in patients with VSD, with or without tricuspid regurgitation.

摘要

目的

探讨全胸腔镜下室间隔缺损(VSD)修补术的安全性和有效性。我们比较了全胸腔镜下 VSD 修补术与小切口开胸术的临床疗效。

方法

我们回顾性分析了 2012 年至 2019 年 1 月间 VSD 患者的临床资料。根据手术方式将患者分为两组:全胸腔镜手术组(36 例,27 例女性,年龄 29±9.52 岁)和小切口开胸组(31 例,12 例女性,年龄 28±8.67 岁)。

结果

两组均无死亡病例。胸腔镜组体外循环(CPB)时间和主动脉阻断(ACC)时间明显长于小切口开胸组(CPB 时间:112±23.16min 比 78±37.90min,p<0.001;ACC 时间:65±19.94min 比 50±24.90min,p<0.001)。胸腔镜组术后住院时间(5.11±2.48d 比 5.90±6.27d,p=0.488)和胸腔引流(139.86±111.71ml 比 196.13±147.34ml,p=0.081)有下降趋势,但无统计学差异。随访时均未发现残余分流或三尖瓣反流。

结论

全胸腔镜下 VSD 修补术治疗 VSD 合并或不合并三尖瓣反流安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eea4/8252479/96ec0d7ba9de/JOCS-36-2213-g002.jpg

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