Clinical efficacy of transthoracic occlusion via a right subaxillary incision and conventional surgery in the treatment of ventricular septal defect: A retrospective cohort study
- VernacularTitle:右腋下切口经胸封堵术与传统外科手术治疗室间隔缺损临床疗效的回顾性队列研究
- Author:
Kun LI
1
;
Qihui SHEN
1
;
Pingfan WANG
1
;
Xiling BAI
1
;
Xiangjie JIA
1
;
Zhenyu WU
1
;
Zheng SONG
1
;
Liwei YAN
1
;
Mingwei WANG
1
Author Information
1. Department of Pediatrics Heart Center, Henan Provincial Chest Hospital, Zhengzhou, 450000, P.R.China
- Publication Type:Journal Article
- Keywords:
Congenital heart disease;
right subaxillary incision;
ventricular septal defect;
conventional surgery;
transthoracic occlusion
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(12):1466-1470
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical efficacy of transthoracic occlusion via a right subaxillary incision and conventional surgery in the treatment of ventricular septal defect (VSD). Methods The clinical data of patients with congenital VSD undergoing right subaxillary incision surgery in our hospital from January 2017 to January 2020 were retrospectively analyzed. According to the surgical methods, the patients were divided into two groups: a conventional surgery group (conventional group) and a transthoracic occlusion group (occlusion group). There were 221 patients in the conventional group, including 97 males and 124 females, with an average age of 2.6±2.2 years and an average weight of 13.4±6.2 kg; there were 185 patients in the occlusion group, including 90 males and 95 females, with an average age of 3.2±2.6 years and an average weight of 14.7±6.6 kg. The clinical effectiveness was compared. Results The success rate of surgery was 100% in both groups. The intraoperative blood loss was less in the occlusion group (P<0.05). The incision length, operation time, postoperative mechanical ventilation time, retention time in the intensive care unit, the time to resume normal diet and normal activities after operation were all shorter than those in the conventional group (P all <0.05). The total cost during hospitalization of the conventional group was less than that of the occlusion group (P<0.001). There was no statistical difference in the incidence rate of perioperative complications between the two groups (P>0.05). During the follow-up (15.8±8.8 months), the incidence of complications in the conventional group was higher than that in the occlusion group with a statistical difference (P<0.001). Conclusion Compared with conventional surgery, transthoracic occlusion for VSD via right subaxillary incision has the advantages of smaller incision, shorter operation time, less blood loss, shorter postoperative recovery time and less long-term complications. However, the total hospitalization cost is relatively high, mainly because of the high consumables cost, and the long-term effects still need further comparative observation.
