WANG Xianyue , YI Dinghua , XU Xuezeng
  • （Department of Cardiovascular Surgery, Xijing Hospital, the Fourth Military Medical University, Xi＇an 710032, P.R.China）;
Totally thoracoscopic surgery; Median sternotomy; Pulmonary function
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Abstract： Objective To find out goodness and weakness by comparing totally thoracoscopic surgery （TTS）and median sternotomy （MS）with cardiopulmonary bypass for pediatric open heart operation. Methods One hundred and fortyseven patients with ventricular septal defect(VSD) and atrial septal defect(ASD) were randomly divided into two groups according to operative methods, TTS group: patients were operated by totally thoracoscopy; MS group: patients were operated by median sternotomy with cardiopulmonary bypass. The clinical records from two groups were compared on operative effect, complications, hospitalization, ventilation time,variations of main data of blood routine test, drainage of pleura cavity, blood loss and transfusion, and pulmonary function. Results There were no death in two groups. There was VSD residual leak the same day after operation which was cured by TTS in one patient of TTS group. There was one case which bleeding was stopped by second operation in MS group. Followup visit were made to 41 patients for 3 months, no heart murmur was detected. The ultrasonic cardiography (UCG) showed that correcting of VSD and ASD were good and had no residual leak. The hospitalization,aortic clampping time, ventilation time and variations of main data of blood routine test, drainage of pleura cavity, blood transfusion and blood loss in TTS group had no significant difference to those in MS group (P gt;0.05). Operating times was longer in TTS group than that in MS group, while stays in the intensive care unit were shorter in TTS group than that in MS group (P lt;0.01). Preoperative and 3 months postoperative pulmonary function of both teams had no statistically significant difference in two groups (P gt;0.05). Conclusion TTS is a safe and effective method to pediatric VSD and ASD as MS is.

Citation： WANG Xianyue,YI Dinghua,XU Xuezeng,YANG Jian,WEI Xufeng,YU Shiqiang.. Totally Thoracoscopic Surgery Versus Median Sternal Incision in Intracardiac Surgery in Pediatrics. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(4): 241-244. doi: Copy