Comparative Study Of MVR In Totally Thoracoscopic Surgery And Right Minithoracotomy

Objective: To observe the thoracoscopic and right thoracic small incision in the implementation of mitral valve replacement(MVR)two groups of patients during perioperative and short-term follow-up in patients with general preoperative data,various tests,surgical data and postoperative complications the differences,thus strengthening the further understanding of the full thoracoscopic MVR and the right chest small incision MVR,to summarize clinical experience.Methods: During the period from February 2012 to June 2017,our department was diagnosed with mitral valve disease through physical examination,electrocardiogram,chest X-ray,and echocardiography.All the patients were adults without any other malformations.MVR therapy was performed to record the medical records of MVR patients undergoing full-chestoscopy and MVR patients with right chest small incision.40 patients were randomly selected for thoracoscopic and right thoracic small incisions and mitral valve replacements.Divided into two groups,the general conditions of the two groups of patients,preoperative and postoperative related examination data,intraoperative transfer time,ascending aortic obstruction time,postoperative ventilator application time,chest drainage,postoperative ICU the clinical data such as stay,postoperative hospital stay and short-term postoperative follow-up were analyzed statistically.Summarizing the reasons for the differences between the two groups of data provides a theoretical basis for the application of different minimally invasive surgical methods.Results: There was no significant difference in the general and preoperative data between the two groups in the thoracoscopic group and the right thoracic small incision group.The right thoracic small incision group was significantly superior to the total thoracoscopy group in the time spent on surgery,cardiopulmonary bypass,and aortic occlusion,and the difference was statistically significant(P<0.05).Simultaneous postoperative correlations occurred in the small right thoracic incision group.There was no significant difference between the disease and the thoracoscopic group.There was no significant difference in ventilator use time,blood transfusion volume,and ICU stay time between the two groups,but the overall length of postoperative hospital stay with right thoracic small incision was significantly less than that of the whole thoracic cavity group,and the difference was statistically significant(P<0.05).The follow-up result was as of August 2017.The minimally invasive group was followed up for 3-12 months.Follow-up 3-64 months,follow-up of 78 people,follow-up rate of 97.5%.No serious postoperative complications occurred in the two groups,including no hospital death,cerebral embolism,cerebral hemorrhage,mechanical valve failure,paravalvular leakage,and hemolysis.Conclusion: There were differences in intraoperative and postoperative parameters between the two groups in the data of the thoracoscopic and right thorax small incisions,but there was no significant difference in the follow-up period.Therefore,the two surgical methods can be applied to the clinical treatment of mitral valve replacement,but the right chest small incision MVR surgery is more conducive to the surgeon to master and operate,so the right chest small incision is relatively suitable for clinical promotion.