THORACOSCOPY VERSUS STERNOTOMY IN THE CORRECTION OF A VENTRICULAR SEPTAL DEFECT: A SINGLE CENTER EXPERIENCE

I. I. Mukhamedov, S. Joshibayev, S.T. Enginoev
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Abstract

Objective: To compare the immediate outcomes of thoracoscopy and median sternotomy in patients undergoing ventricular septal defect repair. Materials and мethods. We analyzed 59 patients diagnosed with VSD who were operated on at the SCCCST from 2012 to 2021. All patients were divided into two groups: group 1 included patients in whom thoracoscopic access was used (n=27), group 2 included the method of complete median sternotomy (n=32). Results. There were no statistically significant differences in complications in the postoperative period and no in-hospital mortality. The duration of the procedure and the duration of cardiopulmonary bypass in the thoracoscopy group were longer than in the sternotomy group. Blood loss during and after surgery was lower in the thoracoscopy group than in the sternotomy group. Hence, less blood and plasma transfusion was required in the thoracoscopy group than in the sternotomy group. The length of stay in the intensive care unit, the time spent on mechanical ventilation, bed days after surgery, the use of analgesics were statistically lower in the thoracoscopy group than in the sternotomy group. It should be noted that the length of the skin incision in patients in the thoracoscopy group was significantly less than in the second group. Conclusion. Thoracoscopic approach for VSD correction is an effective and low-traumatic method that does not increase the risk of surgical complications. Routine use of this technique requires a study on a larger sample of patients.
胸腔镜与胸骨切开术在室间隔缺损矫正中的应用:单中心经验
目的:比较胸腔镜与胸骨正中切开术治疗室间隔缺损的直接疗效。材料和мethods。我们分析了2012年至2021年在SCCCST接受手术的59例诊断为室间隔功能障碍的患者。所有患者分为两组:第一组采用胸腔镜入路(n=27),第二组采用胸骨正中完全切开术(n=32)。结果。两组术后并发症及住院死亡率无统计学差异。胸腔镜组手术时间和体外循环时间均长于开胸术组。胸腔镜组术中及术后出血量均低于开胸术组。因此,胸腔镜组比开胸术组需要更少的血液和血浆输血。在重症监护病房的住院时间、机械通气时间、术后卧床天数、镇痛药的使用方面,胸腔镜组明显低于开胸术组。需要注意的是,胸腔镜组患者皮肤切口的长度明显小于第二组。结论。胸腔镜入路矫正室间隔缺损是一种有效且低创伤的方法,不会增加手术并发症的风险。常规使用这种技术需要对更大的患者样本进行研究。
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