Meta-analysis Of Complete Thoracoscopic Mitral Valve Replacement And Thoracotomy Mitral Valve Replacement In China

Objective:To compare the clinical effect of complete thoracoscopic mitral valve replacement and median thoracotomy mitral valve replacement in order to improve the quality of life of patients with heart valve replacement,so as to improve the quality of life of patients with heart valve Patients get better treatment,and promote the development of cardiac surgery in China.Methods:Through the literature of the medical literature published in the database of Wanfang database,Wipu database,China Knowledge Network and Chinese biomedical database from 2000 to 2016,we collected the relevant articles on complete thoracoscopic contrast with median thoracotomy mitral valve replacement,In accordance with the formulation of the inclusion and exclusion criteria,seven standard-related literatures were finally included in the study,and the quality of all the selected literatures was evaluated.The time of surgery,intraoperative cardiopulmonary bypass,intraoperative ascension Time,postoperative ventilator use time,postoperative ICU monitoring time,postoperative thoracic drainage,postoperative complication rate and postoperative hospitalization time were compared,and RevMan 5.0 software was used for meta-analysis.Results:A total of 781 cases were included in the literature,including 367 cases of complete thoracoscopy group and 414 cases of traditional thoracotomy group.Meta analysis showed that two groups of ascending aorta occlusion time [WMD = 5.86,95% CI(0.18,11.53),P = 0.04],postoperative ventilator use time [WMD =-2.07,95% CI(-3.71,(P = 0.01),postoperative thoracic drainage [WMD =-66.57,95% CI(-119.49,-13.66),P = 0.01],postoperative ICU monitoring time [WMD =-3.57,95% CI(WMD =-3.01,95% CI(-4.52,-1.50),P <0.0001],the incidence of postoperative complications [OR = 0.44,95% CI(0.25,0.79),P = 0.005),the difference was statistically significant;the time of cardiopulmonary bypass [WMD = 5.35,95% CI(-0.89,11.59),P = 0.09],overall operation time [WMD = 0.06,95% CI(-0.25,0.36),P = 0.71],the difference was not statistically significant.Conclusion:In the postoperative thoracic drainage group,the postoperative ventilator use time,postoperative ICU monitoring time,postoperative hospital stay,postoperative complications,the complete thoracoscopic mitral valve replacement group was significantly lower than the middle Thoracic mitral valve replacement group,but complete thoracoscopic mitral valve replacement of the ascending aorta longer than the median thoracotomy valve replacement surgery.There was no significant difference in the overall operation time between the two groups and the time of cardiopulmonary bypass.