关键词: 外科手术, 微创性, 胸腔镜, 心脏缺损, 先天性, 临床方案

Abstract: Abstract: Objective To summarize the clinical experience and the clinical therapeutic effect of minimally invasive surgery for congenital heart disease under thoracoscope. Methods A total of 154 patients of congenital heart disease treated by minimally invasive surgery through thoracoscopic surgery were divided into two groups, adult group (n=112) and minor group (n=42). Through the right chest intercostal incision, thoracoscopic assisted exposure of the surgical field of visual, superior vena cava and femoral vein catheterization, cardiopulmonary bypass were established. The principle of operation was the same as that of thoracotomy. Data of operation time, extraeorporeal circulation time, cross-clamping time, ICU time, length of hospital stay, amount of drainage and the complications were observed in two groups of patients. Results Operations were successful and all patients recovered well. There were no significant differences in operation time, extraeorporeal circulation time, cross-clamping time, ICU time and length of hospital stay between two groups of patients. In adult group, the amount of drainage was significantly increased than that in minor group (P＜0.05). In adult group, there were 4 cases with complications (3.6%), 1 case was changed to median thoracotomy surgery, 1 case was undergone reoperation for bleeding, 1 case had delayed pleural effusion, and 1 case had pneumothorax. In minor group, there were 2 cases with complications (4.8%), 1 case had injury of femoral artery and had bypass operation immediately and 1 case had delayed pleural effusion. There was no significant difference in complications between 2 groups (P＞0.05). There was neither serious complication nor death in both adult and minor groups. Conclusion Minimally invasive thoracoscopic surgery for congenital heart disease is safe and reliable for both adults and minors. It has the advantages of small trauma, less bleeding, less serious complications and quick recovery after operation. However, it takes surgeons some time to grasp the operative skill skillfully, and the operative indication should be controlled strictly.

Key words:  surgical procedures, minimally invasive, thoracoscopes, heart defects, congenital, clinical protocols