Comparison of Clinical Effects Between Totally Video-assisted Thoracoscopic Surgery and Conventional Median Sternotomy for Mitral Valve Replacement
10.3969/j.issn.1009-6604.2015.08.003
- VernacularTitle:完全电视辅助胸腔镜与常规开胸行二尖瓣置换术的临床效果比较
- Author:
Bin WANG
;
Yunge CHENG
;
Nianguo DONG
- Publication Type:Journal Article
- Keywords:
Mitral valve replacement;
Totally video-assisted thoracoscopic surgery;
Conventional median sternotomy
- From:
Chinese Journal of Minimally Invasive Surgery
2015;(8):681-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare clinical effects between totally video-assisted thoracoscopic surgery and conventional median sternotomy for mitral valve replacement . Methods From March 2012 to October 2013, patients with simple mitral valve disease underwent mitral valve replacement through either right chest port -access totally video-assisted thoracoscopy ( thoracoscopy group, n=110) or conventional median sternotomy (conventional group, n=128).The time of operation, cross-clamp ascending aorta, cardiopulmonary bypass , postoperative mechanical ventilation , intensive care unit stay , postoperative hospital stay , and volume of postoperative chest drainage were compared between the two groups .All the patients were followed after 6 months postoperatively for evaluating the condition of valve regurgitation under echocardiography . Results Between the thoracoscopy group and the conventional group, no significant differences were found in time of operation [(256.2 ±28.5) min vs.(251.2 ±30.0) min, t=1.312, P=0.191], cross-clamp time of the ascending aorta [(40.0 ±2.7) min vs.(39.4 ±2.7) min, t=1.709, P=0.089], and cardiopulmonary bypass time [(74.2 ±4.1) min vs.(73.7 ±4.9) min, t =0.846, P =0.399].As compared to the conventional group, the thoracoscopy group had significantly shorter time of postoperative mechanical ventilation [(716.4 ±79.1) min vs.(811.9 ±58.8) min, t=-10.657, P=0.000], shorter length of intensive care unit stay [(26.2 ±3.6) h vs.(29.3 ±4.7) h, t=-5.640, P=0.000], shorter length of postoperative hospital stay [(9.6 ±1.2) d vs.(10.9 ±2.5) d, t=-4.982, P=0.000], and less volume of postoperative chest drainage [(328.1 ±83.2) ml vs.(561.3 ±143.9) ml, t=-14.978, P=0.000], respectively .No death happened in the two groups . No mitral valve regurgitation was seen during follow-ups at 6 months postoperatively . Conclusion For patients undergoing mitral valve replacement , totally video-assisted thoracoscopic surgery is superior to conventional median sternotomy with respect to surgical trauma .
