Comparison Between Occlusion And Repair Of Atrial Septal Defect Through Video-assisted Thoracoscopic Surgical Technique

Objective:To compare the difference between occlusion and repair through video-assisted thoracoscopic surgical technique in atrial septal defect.Methods:A retrospective analysis to clinical data of 83 patients with video-assisted thoracoscopic surgical technique in right thorax,which were from 2003.08 to 2010.12 in Fujian Provincal Hospital , The ages arranged from 3 to 56 years old, including 30 male patients and 53 female patients. 40 cases by surgical occlusion through video-assisted thoracoscope technique (occlusion group), 43 patients by repair surgery by thoracoscope too (repair group). Comparing the two groups in sex, age, weight, size of atrial septal defect, incision size, operation time, postoperative hospitalization days, postoperative blood transfusions, led flow, postoperative complications,treatment success rate, etc.Results:The mean gender between occlusion group and repair group [40(15/25)VS 43(15/28),t=-0.272,p=0.588],age (y) [(23.2 + 16.7) VS (22.7 + 9.2), t = 0.188, p = 0.852], weight (kg) [(40.1 + 18.9) VS (44.3 + 13.1), t = - 1.182, p = 0.241], size of atrial septal defect (cm) [(2.2 + 0.6) VS (2.3 + 0.7), t = - 0.9, p = 0.353] .There were no significant difference above (p > 0.05). However,the incision size (cm) [(2.13 + 0.33) VS (3.51±0.17), t = -23.96, p < 0.001], operation time (min) [(117.0 + 39.6) VS (204.3 + 44.6), t =-9.4, p < 0.001], postoperative hospitalization days (d) [(4.75±0.78) VS (7.33±0.47), t =-18.39, p < 0.001], postoperative blood transfusions (u) [((0.00±0.00) VS (4.19±0.96), t =-27.63, p < 0.001], postoperative lead flow (ml) [(61.38 + 25.18) VS (189.65 + 35.55), t = - 18.84, p < 0.001] had significant difference (p < 0.05). Complications [(5.0% VS 6.9%),χ2=0.143,p=1.000],and success rate ([97.5% VS 100%),χ2=1.088,p=0.482] between the two techniques had no significant difference (p > 0.05) .Conclusion: Two methods were safe and effective in atrial septal defect. The occlusion operation was appropriate for secondary atrial septal defect without other deformity,more mini-invasiver and more simplistic. Repair operation had more widely indications,it was appropriate for atrial septal defect with deformity such as partial pulmonary vein ectopic drainage or tricuspid shut insufficiency. Both of them had obvious advantages in the atrial septal defect, and worthy of clinical application and promotion.